Massive gas embolism following lung inflation for thoracic CT scan in a multiple trauma patient with lung contusions.

We report a case of gas embolism into both right and left circulation in a polytrauma patient with lung contusions, revealed by thoracic CT scan showi ng the heart and aorta filled with gas, It followed a lung inflation with a O-2/N2O mixture for about 30 seconds at a pressure of at least 40 cmH(2)O in order to obtain apnoea for CT scan and to recruit atelectatic territorie s. The presumed mechanism was the passage of the O-2/N2O mixture during the lung inflation manoeuvre out of disrupted airways into torn pulmonary bloo d vessels and pushed back into the heart chambers. The patient recovered fu lly. Lung inflation manoeuvre to obtain a prolonged apnoea during CT scan e xaminations of thorax is contraindicated in case of thorax trauma, as it ca rries a risk of gas embolism. (C) 1998 Elsevier, Paris.