Fatal Gas Embolism During Transurethral Incision of the Bladder Neck Under Spinal Anesthesia

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We report a case of fatal gas embolism during transurethral incision of the bladder neck under spinal anesthesia in a 76-yr-old man. We confirmed the diagnosis of venous gas embolism by aspiration of frothy blood through the double-lumen central venous catheter and by observation on the transesophageal echocardiogram of a massive gas embolism in the right atrium and right ventricle with obstruction of right ventricle outflow. This report is presented in an attempt to remind anesthesiologists of this unusual but potentially fatal complication that may occur during common transurethral surgery.

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