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Korean Journal of Anesthesiology 2002;43(4):525-530.
DOI: https://doi.org/10.4097/kjae.2002.43.4.525   
Perforation of Superior Vena Cava and a Right Pleural Effusion Which Occurred Three Days after Central Venous Catheterization through the Left Subclavian Vein: A case report.
Hyoung Chan Cho, Ju Tae Sohn, Jun Young Choi, Il Woo Shin, Heon Keun Lee, Young Kyun Chung
1Department of Anesthesiology, College of Medicine, Gyeongsang National University, Jinju, Korea. jtsohn@nongae.gsnu.ac.kr
2Department of Thoracic Surgery, College of Medicine, Gyeongsang National University, Jinju, Korea.
3Department of Gyeongsang Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Korea.
Abstract
A 67-year-old male patient had coronary artery bypass graft. Before the induction of general anesthesia, 16 gauge central venous catheter was inserted via left subclavian vein. Initial chest anteroposterior (AP) radiograph showed adequate position, and the central venous pressure measurement through it was satisfactory. This patient's progress was satisfactory, and he was extubated on the second postoperative day. Daily chest AP radiograph had been unremarkable until the third postoperative day, when a right-sided pleural effusion was seen. A day later, the patient complained severe chest pain and dyspnea. We suspected perforation of superior vena cava wall by tip of central venous catheter on the chest computerized tomograph (CT). The injection of radiopaque dye through the central venous catheter confirmed spillage into the mediastinum on the chest CT. Right chest tube was inserted. The patient's condition dramatically improved after chest tube insertion.
Key Words: Central venous catheter; pleural effusion; subclavian vein; superior vena cava


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