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Case Report

Bilateral Pleural Effusion: An Unexpected Complication after Right Subclavian Venous Catheterization for Total Parenteral Nutrition

Rayees Najib* , Rayees Najib* , Suhail Sidiq** , Iram Ali*** , Mohammad Akbar Shah** , Abdul Waheed Mir**

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Indian Journal of Anesthesia and Analgesia 4(1):p 165-167, January - March 2017. | DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4117.28

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Abstract

 Bilateral pleural effusion occurred after total parenteral nutrition was administered via a right subclavian venous line. The most likely explanation for the fluid passage into both pleural cavities was migration of the tip of the catheter from within the vein into the mediastinum. Fluid can pass into both pleural cavities via anatomical communications, yet to be described, which exist between the two pleural cavities1 Central venous catheterization can cause various complications, which are on the whole simple to explain with our current knowledge of anatomy. This case report, however, describes a complication occurring after subclavian venous catheterization, which is difficult to explain with our current knowledge of anatomy. Reports of ipsilateral pleural effusion following misplacement of a central venous catheter are not unusual. However, communications between the two pleural cavities are not known. A similar case of bilateral pleural effusion following a left internal jugular venous cannulation has been reported [1]. A second case of bilateral pleural effusions following an attempted right subclavian venous cannulation has also been reported [2]. No explanation was provided for the complication in either paper.

Keywords: Pleural Effusion; Subclavian Vein; Total Parentral Nutrition.

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DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4117.28

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