scholarly journals Bilateral pleural effusion and pneumomediastinum: rare complication resulting from punctured left subclavian vein following insertion of PICC line for total parenteral nutrition

2021 ◽  
Vol 14 (7) ◽  
pp. e244093
Author(s):  
Saquib Navid Siddiqui ◽  
Muhammad Memon ◽  
Tanveer Hasan
Keyword(s):  
Pleural Effusion ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Subclavian Vein ◽  
Rare Complication ◽  
Venous Catheter ◽  
Left Subclavian Vein ◽  
Chylous Pleural Effusion ◽  
Hypoxic Respiratory Failure ◽  
Picc Line

This is a rare case of development of bi-lateral chylous pleural effusion (containing parenteral nutrition material) along with pneumomediastinum due to punctured left subclavian vein following insertion of a peripherally inserted central venous catheter (PICC) line. Parenteral nutrition is usually preferred for patients unable to tolerate enteral feeding. Due to hypertonicity of the total parenteral nutrition material, it is usually administered via internal jugular or subclavian vein which have a rapid blood flow; therefore, resulting in adequate mixing. Literature studies are yet to clearly explain the communications between two pleural cavities; therefore, development of bilateral pleural effusions in association with pneumomediastinum makes this case more intriguing. We present the journey of a 43-year-old woman who required insertion of bilateral chest drains, followed by sternotomy and repair of the left subclavian vein after she was found in hypoxic respiratory failure 2 days following insertion of PICC line into her left subclavian vein.

scholarly journals Umbilical Venous Catheterization in a Neonate Causing Pleural Effusion

2021 ◽  
Vol 36 (2) ◽  
pp. e242-e242
Author(s):  
Suresh Kotinatot ◽  
Devendra Jadhav ◽  
Ahmed Elajab ◽  
Munira Al Maazmi
Keyword(s):  
Pleural Effusion ◽  
Parenteral Nutrition ◽  
Respiratory Distress ◽  
Total Parenteral Nutrition ◽  
Rare Case ◽  
Rare Complication ◽  
Venous Catheter ◽  
X Ray ◽  
Fluid Analysis ◽  
Venous Catheterization

Pleural effusion is an extremely rare complication in neonates after umbilical venous catheterization that can present with respiratory distress, a neonatal emergency. It needs timely intervention to reduce respiratory distress. We report an interesting and rare case where a term newborn developed right-sided pleural effusion after umbilical venous catheter (UVC) insertion and starting on total parenteral nutrition (TPN). Pleural effusion was confirmed by X-ray and ultrasound and treated with intercostal drainage. The aspirated fluid was TPN, as evidenced by pleural fluid analysis. Pleural effusion resolved after removing the UVC.

scholarly journals Transthoracic Right Atrial Cannulation for Total Parenteral Nutrition — Case Report

1981 ◽  
Vol 9 (1) ◽  
pp. 53-57 ◽  
Author(s):  
L. Hayden ◽  
G. Ramsey Stewart ◽  
D. C. Johnson ◽  
M. McD. Fisher
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Right Atrium ◽  
Venous Catheter ◽  
Right Atrial ◽  
X Ray ◽  
Right Thoracotomy ◽  
Right Atrial Appendage ◽  
The Right ◽  
Nutrition Programme

A man with severe peripheral vascular disease and requiring total parenteral nutrition because of short bowel syndrome was referred because a central venous catheter could not be inserted by conventional techniques. A right thoracotomy was performed and a Hickman catheter inserted via the right atrial appendage into the right atrium. This catheter was used for a total of seven months for total parenteral nutrition. For the last two months of this time, the patient was maintained at home on a Home Parenteral Nutrition Programme. After four months of total parenteral nutrition the patient developed recurrent fevers and the catheter was found to have migrated from the right atrium into the pulmonary artery. The catheter was resited under x-ray control and used for a further three months until the recurrence of fever and dyspnoea heralded the onset of septic pulmonary emboli resulting in his death.

scholarly journals A Case of Successful Conservative Treatment for Chylous Ascites After Living-Donor Liver Transplantation

2013 ◽  
Vol 97 (4) ◽  
pp. 360-362 ◽  
Author(s):  
Hiroaki Shiba ◽  
Shigeki Wakiyama ◽  
Takeshi Gocho ◽  
Yuichi Ishida ◽  
Takeyuki Misawa ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Rare Complication ◽  
Chylous Ascites ◽  
Biliary Cirrhosis ◽  
Donor Liver ◽  
Donor Liver Transplantation

Abstract A 46-year-old man underwent living-donor liver transplantation and splenectomy for primary biliary cirrhosis. On postoperative day 22, cloudiness of ascites increased, and triglyceride concentration in ascites was as high as 1046 mg/dL. With a diagnosis of chylous ascites, total parenteral nutrition was started. Nine days after starting total parenteral nutrition, cloudiness of ascites decreased, and triglycerides in ascites decreased to 93 mg/dL. Oral intake was restarted, and the patient was discharged on postoperative day 46. Chylous ascites is a rare complication after living-donor liver transplantation for which total parenteral nutrition may be useful.

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