Air embolism (a result of direct communication with the vasculature and an external pressure gradient from the gastrointestinal or the biliary tract), although rare, is a potentially devastating adverse event seen in endoscopic retrograde cholangiopancreatography (ERCP) procedures. Whether venous, arterial, or paradoxical, the clinical presentation ranges from asymptomatic patients to cardiorespiratory arrest. This is of particular importance because it makes the diagnosis of air embolism even more difficult in an already sedated patient. Since early recognition increases the chances of patients’ survival, endoscopists should be highly motivated and trained to recognize this complication as early as possible. With only 60 cases of air embolism reported (and even fewer related to paradoxical air embolism), we aimed to report a case of paradoxical cerebral air embolism in a patient undergoing ERCP due to a common bile duct stricture and to provide a mini-review of this clinical entity that can serve as a bedside quick reference guide for endoscopists worldwide.
Case Rep Gastroenterol 2021;15:456–469

中文翻译：

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麻烦时想到气泡：内窥镜逆行胰胆管造影术后脑动脉血栓形成矛盾

空气栓塞（与脉管系统直接连通以及来自胃肠道或胆道的外部压力梯度的结果）虽然很少见，但却是在内窥镜逆行胰胆管造影（ERCP）程序中看到的潜在破坏性不良事件。无论是静脉，动脉还是自相矛盾的，临床表现范围从无症状患者到心肺骤停。这一点特别重要，因为它会使已经镇静的患者的气栓栓塞诊断更加困难。由于早期识别增加了患者存活的机会，因此内镜医师应受到高度的激励和培训，以尽早识别这种并发症。仅报告了60例空气栓塞病例（与矛盾的空气栓塞有关的病例甚至更少），
病例代表胃肠道2021; 15：456–469