Abstract:

Hysteroscopy is a commonly used diagnosis and therapeutic method for gynecological diseases. Air embolism is a rare but extremely serious complication during hysteroscopy. If it is not diagnosed and treated in time, it may lead to irreversible and severe consequences. This paper reports a case of a 24-year-old patient. After 40 days of normal vaginal delivery, the patient was hospitalized for hysteroscopy due to intermittent vaginal bleeding and abnormal echoe in the uterine cavity indicated by ultrasound. During the operation, the patient suddenly became irritable, and her blood pressure, blood oxygen saturation, and partial pressure of end-tidal carbon dioxide (PetCO₂) dropped sharply. After emergency rescue, the patient′s vital signs were temporarily stable and she was transferred to the intensive care unit (ICU) for further treatment. However, due to the recurrence of the condition, the family members finally chose to give up treatment. This case suggests that if symptoms such as irritability, decreased blood pressure, and decreased blood oxygen saturation occur during hysteroscopy, the possibility of air embolism should be highly suspected. Especially when the PetCO₂ is accompanied by a decrease in blood pressure and cannot be explained by hypovolemia, it may be an early warning signal of air embolism. Therefore, early prevention and timely diagnosis are crucial for improving the prognosis.

Key words: Hysteroscopy, Embolism, air, Intraoperative complications, Blood gas analysis, Case reports