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胸腔引流管置入过程中左心室医源性穿孔

Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain.

作者信息

Kim Dongmin, Lim Seong-Hoon, Seo Pil Won

机构信息

Department of Internal Medicine, Dankook University College of Medicine, Korea.

出版信息

Korean J Thorac Cardiovasc Surg. 2013 Jun;46(3):223-5. doi: 10.5090/kjtcs.2013.46.3.223. Epub 2013 Jun 5.

DOI:10.5090/kjtcs.2013.46.3.223
PMID:23772413
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3680611/
Abstract

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

摘要

胸腔引流是治疗胸腔积液的常见操作。心脏穿孔是胸腔引流置管罕见但常致命的并发症。我们报告一例76岁女性充血性心力衰竭患者。就诊时，胸部X线显示左胸单侧模糊影被解释为大量胸腔积液，因此尝试对左胸腔进行引流。由于血液从导管呈搏动性流出，怀疑胸腔引流管位置不当。计算机断层扫描显示左心室穿孔。进行了小切口开胸手术并成功取出引流管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a390/3680611/5a6f9f25dabf/kjtcs-46-223-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a390/3680611/e45dae9336fb/kjtcs-46-223-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a390/3680611/5a6f9f25dabf/kjtcs-46-223-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a390/3680611/e45dae9336fb/kjtcs-46-223-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a390/3680611/5a6f9f25dabf/kjtcs-46-223-g002.jpg

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本文引用的文献

1
Iatrogenic perforation of the left heart during placement of a chest drain.在放置胸腔引流管时，左心发生医源性穿孔。
Diagn Interv Radiol. 2011 Sep;17(3):229-31. doi: 10.4261/1305-3825.DIR.3131-09.0. Epub 2010 Aug 3.
2
Accidental perforation of the left ventricle with a Bonanno catheter.使用博南诺导管时左心室意外穿孔。
J Thorac Cardiovasc Surg. 2009 Apr;137(4):1023-4. doi: 10.1016/j.jtcvs.2008.03.029. Epub 2008 May 27.
3
Accuracy of chest radiograph interpretation by emergency physicians.急诊医生解读胸部X光片的准确性。
BMJ Case Rep. 2019 Apr 8;12(4):e227613. doi: 10.1136/bcr-2018-227613.
4
Unusual Malposition of a Chest Tube, Intrathoracic but Extrapleural.胸管的异常位置，位于胸腔内但在胸膜外。
Case Rep Radiol. 2018 Aug 6;2018:8129341. doi: 10.1155/2018/8129341. eCollection 2018.
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Bradycardia after Tube Thoracostomy for Spontaneous Pneumothorax.自发性气胸行胸腔闭式引流术后的心动过缓
Case Rep Emerg Med. 2018 Mar 19;2018:6351521. doi: 10.1155/2018/6351521. eCollection 2018.
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Intercostal drainage tube or intracardiac drainage tube?肋间引流管还是心内引流管？
Ann Card Anaesth. 2016 Jul-Sep;19(3):545-8. doi: 10.4103/0971-9784.185561.
7
Tube Thoracostomy: A Structured Review of Case Reports and a Standardized Format for Reporting Complications.胸腔闭式引流术：病例报告的结构化综述及并发症报告的标准化格式
World J Surg. 2015 Nov;39(11):2691-706. doi: 10.1007/s00268-015-3158-6.
Emerg Radiol. 2009 Mar;16(2):111-4. doi: 10.1007/s10140-008-0763-9. Epub 2008 Sep 9.
4
BTS guidelines for the insertion of a chest drain.英国胸科学会胸腔引流管置入指南。
Thorax. 2003 May;58 Suppl 2(Suppl 2):ii53-9. doi: 10.1136/thorax.58.suppl_2.ii53.
5
Perforation of the right ventricle: a complication of blind placement of a chest tube into the postpneumonectomy space.
Chest. 1998 Oct;114(4):1213-5. doi: 10.1378/chest.114.4.1213.
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Analysis of tube thoracostomy performed by pulmonologists at a teaching hospital.教学医院肺科医生进行胸腔闭式引流术的分析。
Chest. 1997 Sep;112(3):709-13. doi: 10.1378/chest.112.3.709.
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Interventional radiology of the chest: image-guided percutaneous drainage of pleural effusions, lung abscess, and pneumothorax.胸部介入放射学：影像引导下经皮穿刺引流胸腔积液、肺脓肿和气胸。
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Another complication of thoracostomy--perforation of the right atrium.胸廓造口术的另一个并发症——右心房穿孔。
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