Bhatnagar Malvika, Slight Robert, Prasad Arun Brahmanya, Stanton Andrew Ewing
Department of Respiratory Medicine, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Road, High Heaton, Newcastle Upon Tyne, NE7 7DN, United Kingdom.
Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Road, High Heaton, Newcastle Upon Tyne, NE7 7DN, United Kingdom.
Respir Med Case Rep. 2020 Oct 16;31:101257. doi: 10.1016/j.rmcr.2020.101257. eCollection 2020.
Indwelling pleural catheters [IPC] have an important role in the management of malignant pleural effusions. We report the development of a significant air leak following IPC insertion with resultant extensive subcutaneous emphysema. The air leak developed, presumably, as a result of visceral pleural disruption, which occurred at the time of vacuum drainage of pleural fluid after IPC placement and not due to lung injury during insertion. The patient required insertion of a large bore intercostal drain connected to low-pressure negative suction. He was eventually discharged home with the aid of an ambulatory system. Although commonly seen in the surgical setting, we believe emergency and respiratory physicians should be aware of the risk of such a complication, and the challenges in its management.
留置胸膜导管（IPC）在恶性胸腔积液的管理中发挥着重要作用。我们报告了一例在插入IPC后发生严重漏气并导致广泛皮下气肿的病例。漏气可能是由于脏层胸膜破裂所致，该破裂发生在IPC置入后胸腔积液负压引流时，而非插入过程中的肺损伤。患者需要插入一根连接到低压负压吸引的大口径肋间引流管。最终，他借助一个可移动系统出院回家。尽管这种情况在手术环境中较为常见，但我们认为急诊医生和呼吸科医生应意识到这种并发症的风险及其管理中的挑战。
