However, a massive left hemothorax developed because of perforation of the brachiocephalic vein and violation of the pleural space” Wetzel et al (2017).
An elderly male presented for emergent repair of a ruptured abdominal aortic aneurysm. For anticipated volume resuscitation, vasopressor administration, and hemodynamic monitoring, a large-bore central venous catheter was placed in the left internal jugular vein under ultrasound guidance before surgical incision. Initially, there were no readily apparent signs of venous perforation. However, a massive left hemothorax developed because of perforation of the brachiocephalic vein and violation of the pleural space. This case report discusses both prevention and management of such a complication.
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Wetzel, L.R., Patel, P.R. and Pesa, N.L. (2017) Central Venous Catheter Placement in the Left Internal Jugular Vein Complicated by Perforation of the Left Brachiocephalic Vein and Massive Hemothorax: A Case Report. A & A Case Reports. April 13th. [Epub ahead of print].
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