Published online Jun 6, 2021. doi: 10.12998/wjcc.v9.i16.4024
Peer-review started: January 12, 2021
First decision: February 11, 2021
Revised: February 19, 2021
Accepted: March 13, 2021
Article in press: March 13, 2021
Published online: June 6, 2021
Endoscopic thyroidectomy has obvious advantages over conventional surgical techniques in terms of postoperative cosmetic outcome. Although the incidence of carbon dioxide embolism (CDE) during endoscopic thyroidectomy is very low, it is potentially fatal. The clinical manifestations of CDE vary, and more attention should be paid to this disorder.
A 27-year-old man was scheduled for thyroidectomy by the transoral vestibular approach. The patient had no other diseases or surgical history. During the operation, he developed a CDE following inadvertent injury of the anterior jugular vein. The clinical manifestation in this patient was a transient sharp rise in end-tidal carbon dioxide, and his remaining vital signs were stable. In addition, loud coarse systolic and diastolic murmurs were heard over the precordium. The patient was discharged on day 4 after surgery without complications.
A transient sharp rise in end-tidal carbon dioxide is considered a helpful early sign of CDE during endoscopic thyroidectomy.
Core Tip: Carbon dioxide embolism can occur during endoscopic thyroidectomy and is potentially fatal. The clinical manifestations of carbon dioxide embolism vary. Thus, anesthesiologists should pay more attention when diagnosing and managing such patients.