Journal List > Tuberc Respir Dis > v.60(6) > 1000969

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Kim, Kim, Lee, Kwon, Choi, Beon, Hong, Shin, and Yong: A Case of Pleural Effusion after Malposition of Central Venous Catheter
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Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 60(6): 690-693.

Published online: 30 June 2006

DOI: https://doi.org/10.4046/trd.2006.60.6.690

A Case of Pleural Effusion after Malposition of Central Venous Catheter

Jae Seok Kim, M.D., Sang-Ha Kim, M.D., Nak Won Lee, M.D., Woo Cheol Kwon, M.D.1, Hun Choi, M.D., Jong Won Beon, M.D., Tae Won Hong, M.D., Kye Chul Shin, M.D., Suk Joong Yong, M.D.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

1Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Korea.

Adress for correspondence: Suk Joong Yong, M.D. Department of Internal Medicine, Yonsei University Wonju College of Medicine, 162 Ilsandong, 220-701 Wonju, Korea. Phone: 033-741-0926, Fax: 033-746-4667, sjyong@yonsei.ac.kr

Received 7 September 2005       Accepted 1 June 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Central venous catheterization is used to provide a large amount of fluid, total parenteral nutrition and to administer antitumor agents with few complications reported. We report an uncommon case of pleural effusion that occurred after central venous catheterization. In many cases, the mechanism for the pleural effusion after central venous catheterization occurs through an injury to the superior vena cava by the continuous mechanical force of the catheter tip, the flow of large amount of fluid and an osmotic injury to the wall of the vein. This case is somewhat different in that the central catheter was placed in an aberrant vessel resulting in the pleural effusion. A post-placement chest roentgenogram and the correct approach of catheterization are important for preventing this complication.

Keywords: Central venous catheterization, Complication, Pleural effusion

Figures and Tables

Figure 1
Chest PA after central catheterization via internal jugular vein. The tip of catheter is placed inappropriately.
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Figure 2
Chest PA shows massive hydropneumothorax. The tip of catheter is broken away from the former site.
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Figure 3
Chest CT scan at two weeks after thoracentesis. CT reveals contrast containing pocket (arrow) below the right subclavian vein.
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Figure 4
The tip of catheter which is inserted through the left subclavian vein can be contact with the wall of superior vena cava. (This figure is taken from Texas Heart Institute Journal 1985;12: 389-92.)
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References

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