Atypical presentation of a pneumothorax after eco-guided venous jugular channeling

Martín-Santiago, S.; García-López, R.; Reinaldo Lapuerta, J.A.

doi:10.1016/j.redare.2018.11.011

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Martín-Santiago, R. García-López, J.A. Reinaldo Lapuerta" "autores" => array:3 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Martín-Santiago" "email" => array:1 [ 0 => "sheyla_ms92@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "García-López" ] 2 => array:2 [ "nombre" => "J.A." "apellidos" => "Reinaldo Lapuerta" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Área de Anestesiología y Reanimación, Agencia Sanitaria Hospital Costa del Sol, Marbella, Málaga, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Presentación atípica de neumotórax tras canalización venosa yugular ecoguiada" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 389 "Ancho" => 1255 "Tamanyo" => 83089 ] ] "descripcion" => array:1 [ "en" => "(A) Follow-up chest radiograph, post-placement of the central venous line: Normally positioned catheter (arrow), without evidence of complications. (B) Chest radiograph, 4 days after central venous cannulation, showing the absence of the vasculataure in the right lung base (*). (B) Chest radiograph, 9 days after central venous cannulation, showing predominantly right basal pneumothorax associated atelectasis (*). Maximum depth of the anterior inferior area of pneumothorax is less than 4cm." ] ] ] "textoCompleto" => "A 77-year-old woman, ASA III, with no known respiratory disease and a history of Crohn's disease, presents with ileal abscess and enteral intolerance. A central line is requested for the start of parenteral nutrition.The right internal jugular vein was cannulated using an ultrasound-guided Seldinger technique without apparent difficulty and without clinical or radiographic signs of complication (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A, black arrow). After 48h, the patient exhibited respiratory symptoms (wheezing), which worsened the following day, with dyspnoea, cough and fever. A chest X-ray requested to study this clinical picture was reported to be normal; however, a right basal pneumothorax had been overlooked. One week after venous cannulation, an abdominal-pelvic CT scan was performed due to the patient's digestive pathology, and right basal pneumothorax was observed in the uppermost slices (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C, asterisk). After reviewing the previous radiograph, the previously undetected pneumothorax was observed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> B, asterisk). Over the next few days, the patient was diagnosed serologically with influenza A 2. Evolution of pneumothorax was favourable with conservative treatment.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>It is impossible to know whether the pneumothorax occurred during placement of the central line, or whether it was due to the respiratory comorbidity of the patient. Nevertheless, we must always be mindful of the need for correct diagnosis and proper management." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Martín-Santiago S, García-López R, Reinaldo Lapuerta JA. Presentación atípica de neumotórax tras canalización venosa yugular ecoguiada. Rev Esp Anestesiol Reanim. 2019;66:174–175." ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 389 "Ancho" => 1255 "Tamanyo" => 83089 ] ] "descripcion" => array:1 [ "en" => "(A) Follow-up chest radiograph, post-placement of the central venous line: Normally positioned catheter (arrow), without evidence of complications. (B) Chest radiograph, 4 days after central venous cannulation, showing the absence of the vasculataure in the right lung base (*). (B) Chest radiograph, 9 days after central venous cannulation, showing predominantly right basal pneumothorax associated atelectasis (*). Maximum depth of the anterior inferior area of pneumothorax is less than 4cm." ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006600000003/v1_201903070610/S2341192919300290/v1_201903070610/en/main.assets" "Apartado" => array:4 [ "identificador" => "70433" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006600000003/v1_201903070610/S2341192919300290/v1_201903070610/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192919300290?idApp=UINPBA00004N"]

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Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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Vol. 66. Issue 3.

Pages 174-175 (March 2019)

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