title: Bilateral pneumothoraces following central venous cannulation.
abstract: 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.
authors.affiliation: Division of Anaesthesiology, University Hospitals of Geneva, CH-1211 Geneva, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Pazos
authors.forename: K
authors.initials: K
authors.lastname: Masterson
authors.forename: C
authors.initials: C
authors.lastname: Inan
authors.forename: J
authors.initials: J
authors.lastname: Robert
authors.forename: B
authors.initials: B
authors.lastname: Walder