A conservative surgical approach for management of iatrogenic pulmonary artery perforation
Monodeep Biswas1, Pranjal Kumar Boruah, Lear Von Koch
1The Wright Center for Graduate Medical Education (An affiliate of Temple University, Philadelphia), 746 Jefferson Avenue, Scranton, PA 18510, USA.
Abstract:
Accidental malposition of a chest tube in the pulmonary artery is a potentially fatal complication. Here we describe a 66 year-old obese woman with prior cardiac transplantation, intubated for respiratory failure and felt to have a large left pleural effusion. A chest tube was inserted using a trocar tube, and resulted in near-exsanguinating hemorrhage immediately, with development of hypovolemic shock. Prompt clamping of the tube proved life-saving, and CT scan confirmed placement of the tube in the main pulmonary artery. Initial stabilization, followed by a planned surgical approach, resulted in successful removal of the tube.
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