Tang JX, Wang L, Nian WQ, Tang WY, Xiao JY, Tang XX, Liu HL. Asymptomatic carbon dioxide embolism during transoral vestibular thyroidectomy: A case report. World J Clin Cases 2021; 9(16): 4024-4031 [PMID: 34141762 DOI: 10.12998/wjcc.v9.i16.4024]
Corresponding Author of This Article
Hong-Liang Liu, MD, PhD, Chief Doctor, Director, Department of Anesthesiology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. liuhl75@163.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jia-Xi Tang, Jing-Yu Xiao, Xi-Xi Tang, Hong-Liang Liu, Department of Anesthesiology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
Ling Wang, Wei-Qi Nian, Wan-Yan Tang, Department of Phase I Clinical Trial Ward, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
Author contributions: Tang JX was the anesthesiologist and wrote the manuscript; Tang JX, Wang L, Nian WQ, Tang WY and Tang XX conceived and designed the report; Tang JX and Xiao JY collected and prepared the images; Liu HL reviewed and confirmed the final version of the manuscript; all authors have read and approved the final manuscript.
Supported byScience and Technology Bureau of Shapingba District, Chongqing, China, No. JCD202041; and Science and Technology Bureau of Chongqing, China, No. CSTC2019JXJL130029.
Informed consent statement: The patient involved in this study gave written informed consent authorizing the use and disclosure of his protected health information. The study protocol was approved without restrictions by the Medical Ethics Committee of the Institute of Chongqing University Cancer Hospital.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Liang Liu, MD, PhD, Chief Doctor, Director, Department of Anesthesiology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. liuhl75@163.com
Received: January 12, 2021 Peer-review started: January 12, 2021 First decision: February 11, 2021 Revised: February 19, 2021 Accepted: March 13, 2021 Article in press: March 13, 2021 Published online: June 6, 2021 Processing time: 122 Days and 2.4 Hours
Abstract
BACKGROUND
Endoscopic thyroidectomy has obvious advantages over conventional surgical techniques in terms of postoperative cosmetic outcome. Although the incidence of carbon dioxide embolism (CDE) during endoscopic thyroidectomy is very low, it is potentially fatal. The clinical manifestations of CDE vary, and more attention should be paid to this disorder.
CASE SUMMARY
A 27-year-old man was scheduled for thyroidectomy by the transoral vestibular approach. The patient had no other diseases or surgical history. During the operation, he developed a CDE following inadvertent injury of the anterior jugular vein. The clinical manifestation in this patient was a transient sharp rise in end-tidal carbon dioxide, and his remaining vital signs were stable. In addition, loud coarse systolic and diastolic murmurs were heard over the precordium. The patient was discharged on day 4 after surgery without complications.
CONCLUSION
A transient sharp rise in end-tidal carbon dioxide is considered a helpful early sign of CDE during endoscopic thyroidectomy.
Core Tip: Carbon dioxide embolism can occur during endoscopic thyroidectomy and is potentially fatal. The clinical manifestations of carbon dioxide embolism vary. Thus, anesthesiologists should pay more attention when diagnosing and managing such patients.
