Tuberc Respir Dis.  2006 Jun;60(6):690-693. 10.4046/trd.2006.60.6.690.

A Case of Pleural Effusion after Malposition of Central Venous Catheter

• Kim JS
• Kim SH
• Lee NW
• Kwon WC
• Beon JW
• Hong TW
• Shin KC
• Yong SJ

• KMID: 1630809
• DOI: http://doi.org/10.4046/trd.2006.60.6.690

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.

Keyword

Central venous catheterization; Complication; Pleural effusion

MeSH Terms

Antineoplastic Agents
Catheterization
Catheterization, Central Venous
Catheters
Central Venous Catheters*
Parenteral Nutrition, Total
Pleural Effusion*
Thorax
Veins
Vena Cava, Superior
Antineoplastic Agents

Figure

• 

  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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