Fatal air embolism following perforation of the cecum in a patient with peritoneovenous shunt for ascites.

The authors report the occurrence of fatal embolism as a complication of a LeVeen peritoneovenous shunt performed four months previously in a 67-year old man with ascites. Air embolism was caused by perforation of the cecum following cauterization of a vascular malformation of the mucosa through a flexible colonoscope. An autopsy demonstrated air within the peritoneal cavity, the LeVeen shunt and both ventricles of the heart. In the patient with a LeVeen shunt, gastrointestinal perforation from any cause is an indication for immediate closure of the shunt.