A 52-year-old woman with ovarian cancer III C (malignant adenocarcinoma) diagnosed 2 years earlier.
Treatment consisted of total hysterectomy, bilateral omentectomy, omentectomy and ileocolic resection, in addition to chemotherapy and ileostomy due to intestinal obstruction.
Due to persistent vomiting lasting two weeks, an outpatient upper endoscopy was performed.
Intravenous midazolam 4.5 mg was used for sedation.
Endoscopy showed extensive colitis in the middle and distal thirds, biopsies were taken from these areas.
During the procedure she presented consciousness compromise that did not revert with flumazenil.
His general physical examination revealed a heart rate of 100 per min and hypotension (90/50), which did not respond to volume infusion.
Neurological examination revealed bilateral desymmetric weakness and stiffness in the lower limbs, right deviant eyes, reflexes or cephalads present, absent corneal reflex in four limbs NIH scale, hypertonia
It was decided to transfer the patient to the recovery room of the emergency department and an encephalon computed tomography (CT) was requested, which showed multiple air embolisms in the right border area between the middle and anterior cerebral arteries.
The chest X-ray was normal.
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The treating oncological team decided, together with the patient's family, a conservative management due to the poor prognosis of the underlying neoplasm, indicating transfer to the room and 100% oxygen.
The patient died 48 hours later without recovery of consciousness or neurological deficits.
Biopsy of the oesophagus revealed intense and diffuse colitis of the middle and distal third, which was secondary to chemotherapy.
