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Air embolism: a complication during transcervical resection of the endometrium.

T here has been enormous worldwide interest in a simple surgical alternative to abdominal or vaginal hysterectomy. Endometrial resection (TCRE) with the use of the resectoscope has been considered as an alternative to hysterectomy for the treatment of intractable uterine bleeding (1). The procedure is similar to transurethral resection of the prostate (TURP) in terms of technique and the use of a liquid medium such as 1.5% glycine for distension and irrigation of the uterus. Absorption of a large volume of fluid can cause excessive intravascular volume, hyponatremia (2), cerebral edema (3–5), hyperammonia (6), hyperglycinemia (7), and hemolysis. Air embolism, although rare, is a possible complication during TCRE. With the use of loop diathermy for endometrial ablation, air embolism can occur during surgery whenever the vein is open or when air pressure exceeds the venous system (8). We report a case of air embolism during TCRE.