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Systemic Air Embolism following CT-guided Lung Biopsy

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Clinical Case

OUR institutional review board does not require approval for submission of retrospective reports such as this. A 39-year-old female patient with long-term history of heavy smoking presented to the emergency room with dyspnea and underwent a computed tomography (CT) scan of the chest as part of her evaluation. A left upper-lobe peripheral lesion was detected, along with hilar lymph nodes, with possible encasement of the left pulmonary artery by the hilar nodes (not shown). She was referred to

What Happened and Why Did It Happen?

The patient developed air embolism. She coughed twice after the first pass of the core biopsy needle. It is likely that transient communication between the pulmonary vein and the biopsy tract may have been present at that time, resulting in alveolar or bronchial air passing into the pulmonary vein, as a result of the increased intrapulmonary pressure induced by the coughing. The air subsequently passed into the left atrium and then into the left ventricle. The subsequent clinical events arose

Discussion

Pneumothorax and hemorrhage are commonly encountered complications of transthoracic/percutaneous procedures including aspiration and biopsy (1). Air embolism is a known, rare complication of thoracic needle aspiration and biopsy. Its incidence has been noted to be low (2, 3, 4), ranging from 0.02% to 0.4%. Reports in the literature have described fatal outcomes (5) as well as nonfatal and even asymptomatic outcomes (2, 6, 7) following development of the complication. Symptoms and sequelae arise

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The author has not identified any conflicts of interest.

Sameer Bhatia is a shareholder in J&J (unrelated to this article).

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