Fatal air embolism during intestinal endoscopy in Kasai portoenterostomy for biliary atresia: A case report

Figure 2 Intraoperative endoscopic view of stone. A: Intraoperative endoscopic findings in an unpublished previous case of a Kasai portoenterostomy (KPE) site stone, experienced 14 years ago, showing a black pigmented stone hanging like a stalactite from the KPE site and a tiny opening of a bile ductule (arrow). Endoscopic removal of the stone resolved the cholangitis and prevented further development of cholangitis in this case; B: Intraoperative endoscopic findings in the current case showing a large thick bile sludge-like lump hanging from the KPE site, which was easily broken during endoscopic removal. Three minutes after starting the endoscope examination, a sudden fatal air embolism occurred, and the patient died.