Bilateral Pneumothoraces Following Central Venous Cannulation

الملخص EN

We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient.

The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery.

Two days earlier, she had a median laparotomy under general and epidural anaesthesia.

Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air.

We punctured the right pleural space before cannulation of the right subclavian vein.

After the procedure, the patient slowly became hemodynamically instable with respiratory distress.

A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax.

The right-side pneumothorax became under tension after left chest tube insertion.

The symptoms finally resolved after insertion of a right chest tube.

After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax.