Iatrogenic pneumothorax

Case contributed by Seamus O'Flaherty

Presentation

Pulmonary valve replacement for pulmonary regurgitation. Admission to intensive care unit post-operatively.

Patient Data

Age: 40 years
Gender: Female
x-ray

Moderate sized pneumothorax right lung. 

Right internal jugular central venous access device with tip in SVC. Endotracheal tube in situ. Mediastinal drain tube in situ. 

Case Discussion

This patient was admitted to intensive care following a pulmonary valve replacement. The pneumothorax was noted on admission chest x-ray. The patient was asymptomatic. The surgical team state they did not breach the right hemithorax and had good vision of it at all times.

Suspected iatrogenic pneumothorax from right internal jugular central venous device insertion. 

The patient was monitored and the pneumothorax resolved without requiring an intercostal catheter. A three-way valve dressing was applied to the soft tissue tract when the central venous access device was removed.

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