Venous Air Embolism: A Rare but Possible Complication During Retrograde Intrarenal Surgery-A Case Report and Review of Literature

Background: Venous air embolism (VAE) during various urologic surgeries such as transurethral resection of prostate, percutaneous nephrolithotomy (PCNL) and occasionally while performing air pyelogram during PCNL have been reported in the literature. Case Presentation: In this study, we present a case of 34 year-old gentleman who developed intraoperative VAE during retrograde intrarenal surgery (RIRS). The clinical suspicion and diagnosis were made by fall in end-tidal carbon dioxide and oxygen saturation, transient hypotension, and bradycardia. The patient was managed conservatively. The most important factor was timely detection and early management by the anesthetist. Conclusion: To our knowledge, this is the first case of VAE reported during RIRS. For procedures such as RIRS complicating to VAE, a high index of suspicion and prompt management is required.