Occurrence of cerebral CO2 embolism during laparoscopic adrenalectomy: a case report and review of the literature

Abstract

Background: CO₂ embolism has been documented in a range of laparoscopic procedures, and cerebral CO₂ embolism is an extremely rare but lethal incidence of CO₂ embolism, which may ultimately result in coma, stroke, disability, and mortality.

Case presentation: This paper presents an uncommon case of cerebral CO₂ embolism that occurred during laparoscopic surgery, along with a thorough examination of existing literature. The patient (56-year-old Chinese female) experienced a loss of consciousness, generalized tonic-clonic seizures, and neurological impairments after undergoing a laparoscopic partial adrenalectomy. Multiple low-density lesions were detected by brain magnetic resonance imaging. The patient exhibited improvement and gradual recovery after undergoing therapies such as continuous hyperbaric oxygen therapy, hypothermic brain protection, hormone therapy, and anticoagulation.

Conclusion: We emphasize that cerebral CO₂ embolism is a significant complication that must be given great importance in laparoscopic surgery. The comprehension of cerebral CO₂ embolism, and effective communication between surgeons and anesthesiologists, play a crucial role in its diagnosis and avoiding inadequate treatment.

Keywords: Case report; Cerebral CO2 embolism; Laparoscopic surgery; Literature review.