Pulmonary oedema following venous air embolism during transsphenoidal pituitary surgery.

Venous air embolism (VAE) is a well known complication in procedures where the operative field is above the level of the heart. Acute pulmonary oedema after a large air embolus occurring during neurosurgery is also a recognized phenomenon. However, pulmonary oedema following repeated episodes of VAE in sublabial transsphenoidal (SLTS) surgery for pituitary adenoma has never been reported. We describe a case of VAE in a 65 year old male undergoing SLTS surgery for pituitary adenoma. Following this, the patient had pulmonary oedema which resolved on supportive treatment. Pulmonary oedema as a result of VAE may go unrecognised intraoperatively but can lead to a significant postoperative morbidity. Early suspicion and recognition of VAE and institution of aggressive treatment will help to avoid fatal consequences.