Fraser R S
Department of Pathology, McGill University, Montreal, Quebec, Canada.
Hum Pathol. 1987 Dec;18(12):1246-51. doi: 10.1016/s0046-8177(87)80408-2.
Perforation of the pulmonary artery due to insertion of a balloon-tipped, flow-directed (Swan-Ganz) catheter is described in four cases. These cases were found in a consecutive series of 270 autopsies done over a 1.5-year period and suggest that the incidence of this complication may be greater than the number of clinically reported cases implies. In three instances, a focal parenchymal hematoma or thrombotic nodule identified the site of rupture. Other pathologic features and the pathogenesis of the perforation are discussed. Difficulties in postmortem diagnosis include distinguishing perforation from hemorrhage due to trauma, thromboembolism, and coagulation abnormalities.
本文描述了4例因插入带球囊尖端、血流导向（Swan-Ganz）导管导致肺动脉穿孔的病例。这些病例来自于在1.5年期间连续进行的270例尸检，提示该并发症的发生率可能高于临床报告病例数所显示的。在3例中，局灶性实质血肿或血栓性结节确定了破裂部位。文中还讨论了其他病理特征及穿孔的发病机制。尸检诊断的困难包括区分穿孔与创伤、血栓栓塞及凝血异常所致的出血。
