Jugular Air Embolism
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Description
A 72-year-old man with a three days history of fever and stranguria was admitted to our Emergency Department. After clinical evaluation, laboratory and radiologic data, the final diagnosis was septic shock due to pyelonephritis. The SOFA score was 8. Empirical antibiotics were started after urine and blood-culture samples were obtained. In this setting, an integrated clinical ultrasound was performed: IVC was 17 mm in diameter with an inspiratory collapsibility of more than 50%; cardiac ultrasound showed an eyeball ejection fraction of 20-25% with an apparent enlarged left ventricle, a grade 2 diastolic dysfunction with a E/E’ ratio of 7; the right chambers was normal; chest ultrasound showed an A-profile with a bilateral normal basal curtain sign [1]. Need of vasopressors and inotropes was hypothesized because of persistence of shock even if a normalized fluid status. Afterwards, a central venous catheter was necessary. While pre-procedural ultrasound imaging of central veins for vascular access was performed, gas emboli were noted in the left internal jugular vein. These emboli are recognized as hyperechoic bubbles in the anterior wall of the vessel, with reverberation artifacts extending deeper occupying almost the vein lumen .....

https://www.omicsgroup.org/journals/jugular-air-embolism-2165-7548-1000289.php?aid=64040
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