title: Bilateral chylothorax as a complication of internal jugular vein cannulation.
abstract: Central venous catheterization is one of the most prevalent procedures in the Intensive Care Unit. Complications are reported in about 15% of the patients and usually comprise of infection, arterial puncture, malpositioning, pneumothorax, local hematoma, hemothorax, and so on. Chylothorax is a rare complication of this procedure. We present a 42-year-old lady, who developed bilateral massive chylothorax after cannulation of her left internal jugular vein (IJV), due to direct injury to the thoracic duct during the procedure. The patient was successfully managed with bilateral chest tube drainage and omission of oral feeds for four days. Development of bilateral chylothorax as a complication of IJV cannulation is rare, but merits reporting, in view of a large number of central venous cannulations being undertaken. Critical care professionals should be aware of this rare complication of a common procedure to facilitate early identification and institute appropriate therapy.
authors.affiliation: Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
authors.forename: Puneet
authors.initials: P
authors.lastname: Saxena
authors.affiliation: Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
authors.forename: Subramanian
authors.initials: S
authors.lastname: Shankar
authors.affiliation: Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
authors.forename: Nardeep
authors.initials: N
authors.lastname: Naithani
keywords: Bilateral; central venous catheters; chylothorax; complication; internal jugular vein cannulation; thoracic duct