Panza Teodora, Quercia Rosatea, Signore Francesca, De Iaco Giulia, Brascia Debora, Sampietro Doroty, Gasbarro Anna Rita, Dell'Aera Maria, Lorusso Vito, Marulli Giuseppe, De Palma Angela
Unit of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro," Bari, Italy.
Pharmacy Unit, University Hospital Polyclinic of Bari, Bari, Italy.
Front Surg. 2022 Jul 26;9:921968. doi: 10.3389/fsurg.2022.921968. eCollection 2022.
Dislocation or wrong placement of central venous catheters into the pleural cavity is rare, but if undiagnosed, may cause major, sometimes life-threatening, complications (pneumothorax, hemothorax, infection, and migration) and accidental pleural effusion due to intravenous injection of fluids containing drugs (i.e. chemotherapy, antibiotics, parenteral nutrition, other). We report a rare case of pleural effusion consisting of chemotherapy (chemothorax) directly injected into the pleural cavity due to the wrong placement of a central venous catheter (Porth-A-Cath) in a woman with breast cancer. A multidisciplinary management consisting of antidote administration, followed by removal of the venous device and washing of the pleural cavity through video-assisted thoracic surgery (VATS), avoided any major complication related to the adverse event.
中心静脉导管移位或错误置入胸腔的情况较为罕见，但如果未被诊断出来，可能会引发严重的、有时甚至危及生命的并发症（气胸、血胸、感染和移位），以及因静脉注射含药液体（如化疗药物、抗生素、肠外营养制剂等）导致的意外胸腔积液。我们报告了一例罕见的胸腔积液病例，一名乳腺癌女性因中心静脉导管（Porth-A-Cath）错误置入胸腔，导致化疗药物直接注入胸腔（化学性胸腔积液）。通过多学科管理，先给予解毒剂，随后移除静脉装置，并通过电视辅助胸腔镜手术（VATS）冲洗胸腔，避免了与该不良事件相关的任何严重并发症。
