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March 30, 1940


JAMA. 1940;114(13):1285. doi:10.1001/jama.1940.02810130147025

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To the Editor:—  In the February 24 issue of The Journal appeared an article on "Death from Air Embolism Following Perirenal Insufflation" by Dr. Henry J. Weyrauch Jr. In my experience, which consists of eighty perirenal insufflations, there was never any untoward complication.Granting that the needle is passed properly and that no blood is aspirated, I believe that the most important safeguard in the procedure of insufflation is dependent on the type of delivery system employed. I have never used any other system than a two bottle pneumothorax machine which delivers air under gravity pressure at about an 8 inch level. With this type of system the gas flows under relatively low pressure, at least a pressure low enough so that if the needle should be within the kidney substance or within abdominal musculature there will be no flow of the gas. If the needle is within the perirenal

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