Abstract：
Gas embolization is a rare but potentially deadly complication of any laparoscopic surgery. There has only been one other report of gas emboli in patients undergoing bariatric surgery. We present a case of gas embolization in a young female patient undergoing Roux-en-Y gastric bypass. Onset of gas embolus was identified by a dramatic drop in End Tidal Carbon Dioxide (ETCO2) followed by drops in blood pressure, heart rate, and oxygen saturation over the following 15 minutes before the patient was stabilized and transferred to the ICU. The surgery was completed three days later without incident, and extensive hepatomegaly was identified. A discussion on pre-operative evaluation, special considerations, and acute management of gas embolization in patients with obesity ensues. We highlight the emerging Jain\'s point for insufflation, the potential for ultrasound-guided Verres needle insertion, and the paucity of literature evaluating the risk, incidence, and outcomes of gas embolization in patients with obesity.
摘要：
气体栓塞是任何腹腔镜手术的罕见但潜在致命的并发症。在接受减肥手术的患者中，只有另一份关于气体栓塞的报道。我们介绍了一名接受Roux-en-Y胃旁路术的年轻女性患者的气体栓塞病例。气体栓子的发作是由潮汐末二氧化碳（ETCO2）的急剧下降以及血压的下降确定的，心率,在患者稳定并转移到ICU之前的15分钟内和氧饱和度。手术三天后完成，没有发生意外，发现了广泛的肝肿大。关于术前评估的讨论，特殊考虑,以及肥胖患者气体栓塞的急性处理。我们强调新兴的Jain的吹气点，超声引导的Verres针插入的潜力，以及缺乏评估风险的文献，发病率,和肥胖患者的气体栓塞的结果。
