Inadvertent puncture of the thoracic duct during attempted central venous catheter placement

We report a case of puncture of the thoracic duct during left subclavian vein catheterization on the intensive care unit. Computed tomography and measurement of the triglyceride levels in the aspirated fluid proved the inadvertent penetration of the guidewire into the thoracic duct. Early recognitio...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2003-11, Vol.26 (6), p.569-571
Main Authors: TEICHGRABER, Ulf K. M, NIBBE, Lutz, GEBAUER, Bernhard, WAGNER, Hans-Joachim
Format: Article
Language:English
Subjects:
Biological and medical sciences
BODY FLUIDS
Cardiology. Vascular system
Catheterization, Central Venous - adverse effects
COMPUTERIZED TOMOGRAPHY
Humans
INFUSION
Investigative techniques, diagnostic techniques (general aspects)
LYMPH VESSELS
Male
MEDIASTINUM
Medical sciences
Middle Aged
Punctures - adverse effects
Radiography
RADIOLOGY AND NUCLEAR MEDICINE
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Thoracic Duct - diagnostic imaging
Thoracic Duct - injuries
TRIGLYCERIDES
VEINS
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Summary:We report a case of puncture of the thoracic duct during left subclavian vein catheterization on the intensive care unit. Computed tomography and measurement of the triglyceride levels in the aspirated fluid proved the inadvertent penetration of the guidewire into the thoracic duct. Early recognition of central line misplacement avoided serious complications. Inadvertent central venous catheter placement into the thoracic duct may have the potential complications of infusion mediastinum and chylothorax.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-003-0102-1