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December 13, 1941

AIR EMBOLISM IN ARTIFICIAL PNEUMOTHORAX

Author Affiliations

HOUSTON, TEXAS; SANATORIUM, TEXAS
From the Texas Tuberculosis Sanatorium, Sanatorium, Tom Green County, Texas.

JAMA. 1941;117(24):2064-2069. doi:10.1001/jama.1941.02820500046010
Abstract

Of all the complications of artificial pneumothorax therapy, air embolism is the most alarming and most dangerous. Its occurrence is sudden and without preceding signs or symptoms, as it is in reality an accident. Its results either are instantaneous or appear in a short time.

Rogers, while irrigating the empyema cavity of a small girl in 1864, observed an attack characterized by pallor, unconsciousness and clonic convulsions with recovery after twenty-four hours. While diagnosed as pleural eclampsia it may be logically assumed from the description of the attack that this was a case of cerebral air embolism.

Brandes1 in 1912, while attempting to outline an empyema cavity with bismuth paste, accidentally demonstrated the mechanism of air embolism. On injection of the paste, the patient became unconscious and was suddenly seized with fatal convulsions. On postmortem examination bismuth was found in the vessels of the cerebral cortex and brain stem.

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