Maemura Keita, Kage Hidenori, Isago Hideaki, Takeshima Hideyuki, Makita Kosuke, Amano Yosuke, Takai Daiya, Ohishi Nobuya, Nagase Takahide
Department of Respiratory Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.
Case Rep Pulmonol. 2018 May 7;2018:7108215. doi: 10.1155/2018/7108215. eCollection 2018.
Cerebral arterial air embolism (CAAE) is an extremely rare complication of diagnostic flexible fiberoptic bronchoscopy, reported to occur once about every 103978 examinations. In all the eight cases of CAAE reported previously, the patients had undergone transbronchial lung biopsy (TBLB) or transbronchial needle aspiration (TBNA) prior to the onset of CAAE. Herein, we describe the case of a 77-year-old patient with double primary lung cancer who developed CAAE after bronchial curette cytology, which is considered to be less invasive than TBLB or TBNA. The patient was treated with supplemental oxygen, but paresis of the left upper arm and left spatial neglect remained. This is the first report of CAAE occurring after bronchial curettage during diagnostic flexible fiberoptic bronchoscopy.
脑动脉空气栓塞（CAAE）是诊断性可弯曲纤维支气管镜检查极为罕见的并发症，据报道大约每103978次检查中会出现1例。在先前报道的所有8例CAAE病例中，患者在CAAE发作前均接受了经支气管肺活检（TBLB）或经支气管针吸活检（TBNA）。在此，我们描述了1例77岁双原发性肺癌患者，在支气管刮匙细胞学检查后发生了CAAE，而支气管刮匙细胞学检查被认为比TBLB或TBNA侵入性更小。患者接受了补充氧气治疗，但左上臂麻痹和左侧空间忽视仍然存在。这是诊断性可弯曲纤维支气管镜检查期间支气管刮除术后发生CAAE的首例报告。
