کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2741608 | 1148544 | 2009 | 4 صفحه PDF | دانلود رایگان |
Hemothorax resulting from perforation of a great vessel is an uncommon but life-threatening complication which may occur during central venous insertion of a hemodialysis catheter. We describe a 78-year-old uremic female who developed unexplained and refractory shock on the completion of percutaneous placement of a hemodialysis catheter in the right subclavian vein under general anesthesia. Bedside transthoracic ultrasound revealed a large anechoic area above the right hemidiaphragm, suggestive of the presence of extensive hemothorax. The diagnosis was further confirmed by prompt drainage of fresh blood from the right thoracostomy tube. Emergent thoracotomy was performed and perforation of the superior vena cava was identified. Hemodynamic stability was restored after surgical repair of the injured vessel, aggressive volume resuscitation and inotropic/vasopressor treatment. This case suggests that portable ultrasonography is an invaluable bedside tool which allows anesthesiologists to made reliable and prompt diagnosis of potentially fatal complications, such as perforation of great central vein due to inadvertent cannulation.
Journal: Acta Anaesthesiologica Taiwanica - Volume 47, Issue 2, June 2009, Pages 95-98