CO2-gas-embolism following accidental vessel punction during laparoscopic cholecystectomy

We report a case of carbon dioxide (CO2) embolism in a 52-year-old man duri ng a laparoscopic cholecystectomy,which caused an accidental CO2-insufflati on in a vessel despite exact control of the Verres needle. The first manife stations were two drops of the partial pressure of endtidal carbon dioxide (PETCO2) from 34 mmHg to 13 mmHg and again from 37 mmHg to 11 mmHg,followed by pulseless ventricular tachycardia. It was possible to achieve resuscita tion and a recompensation of the right heart failure with drug therapy. Aft er successful resuscitation and restoration of a stable hemodynamic situati on,an abrupt increase in the PETCO2 from 11 mmHg to 52 mmHg was noted. This increase of PETCO2 could be interpreted as the reinstallation of circulati on and the amount of CO2 in the organism after carbon dioxide embolism.