Bilateral Pneumothoraces Following Central Venous Cannulation

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Pazos, F. ; Masterson, K. ; Inan, C. ; Robert, J. ; Walder, B. (2009)
  • Publisher: Hindawi Publishing Corporation
  • Journal: Case Reports in Medicine, volume 2,009 (issn: 1687-9627, eissn: 1687-9635)
  • Related identifiers: doi: 10.1155/2009/745713, pmc: PMC2773426
  • Subject: R | Case Report | Medicine | Article Subject

We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax.
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