Tayama K, Inoue T, Yokoyama H, Yano T, Ichinose Y
Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
Surg Today. 1996;26(10):837-8. doi: 10.1007/BF00311650.
We report herein the case of a 47-year-old woman who suffered a hydrothorax induced by a central venous catheter (CVC) which had been placed to facilitate total parenteral nutrition following a left sleeve pneumonectomy for lung cancer. The CVC was inserted into the superior vena cava (SVC) through the left subclavian vein after the operation; however, the tip inadvertently turned upward and came in contact with the lateral wall of the SVC. The patient suddenly developed dyspnea due to a right-sided hydrothorax 47 days after the insertion of the catheter. Indocyamine green administered through the catheter was thereafter found in the pleural fluid. The continuous mechanical force of the catheter tip against the SVC wall was thus considered to be the cause of this life-threatening delayed hydrothorax.
我们在此报告一例47岁女性病例，该患者因中心静脉导管（CVC）引发胸腔积液。该导管是在患者因肺癌接受左肺袖状切除术后为便于全胃肠外营养而放置的。术后经左锁骨下静脉将CVC插入上腔静脉（SVC）；然而，导管尖端意外向上弯曲并接触到SVC侧壁。导管插入后47天，患者突然因右侧胸腔积液出现呼吸困难。此后发现通过导管注入的吲哚菁绿出现在胸腔积液中。因此，认为导管尖端对上腔静脉壁的持续机械力是导致这种危及生命的迟发性胸腔积液的原因。
