Pulmonary Artery Pseudoaneurysm After Tube Thoracostomy

Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended.

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“…Injuries to the pulmonary artery and pulmonary artery pseudoaneurysm are rare serious complications of chest tube insertion [59–62]. …”

Section: Complicationsmentioning

confidence: 99%

Tube Thoracostomy: Complications and Its Management

et al. 2012

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“…The formation of a pseudoaneurysm after pulmonary artery injury has been reported to occur anywhere between minutes to months after the precipitating event and carries a significant risk of rupture which may be fatal in 50% of patients (Podbielski et al, 1997). These pseudoaneurysms may also be asymptomatic and therefore may not be diagnosed for many years (Savage et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…These pseudoaneurysms may also be asymptomatic and therefore may not be diagnosed for many years (Savage et al, 2001). The most common symptom at the time of presentation is haemoptysis (Reade et al, 2006), however, shortness of breath, chest pain, cough and hypoxia may also be the presenting complaint (Podbielski et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary artery pseudoaneurysm following blunt trauma

Dimmick

Briggs

Maher

2012

Trauma

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Blunt trauma is a rare cause of pulmonary artery pseudoaneurysm. We report a case of a pseudoaneurysm of the right pulmonary artery sustained after a high speed motor vehicle accident, identified on multidetector CT imaging of the chest. After initial resuscitation, the patient remained haemodynamically stable and surgical management, with patch repair, was undertaken 4 days after the trauma. The patient was discharged without complication and follow-up imaging revealed no residual pseudoaneurysm. This case report highlights the need to assess both the aorta and pulmonary arteries on CT of the chest for potential sites of vascular injury.

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“…Injury to the pulmonary artery (PA) can occur in blunt and penetrating chest trauma 24 but is more likely to be caused iatrogenically. Rupture or pseudoaneurysm of the PA has been reported after chest tube insertion 25 and more commonly as a complication of Swan-Ganz catheter manipulation. [26][27][28][29][30][31] Perforation of the PA typically presents with massive hemoptysis.…”

Section: Pulmonary Arterymentioning

confidence: 99%

Embolization Techniques in Trauma of the Chest

Fox

Brady²,

Swischuk

et al. 2000

Semin intervent Radiol

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This article describes transcatheter embolization as an alternative to surgical ligation in controlling hemorrhage from noncritical arteries of the chest wall after blunt or penetrating trauma. Embolotherapy is also discussed as the treatment of choice for pulmonary artery injury from Swan-Ganz catheter manipulation resulting in pseudoaneurysm formation. Embolic agents and technique are briefly reviewed.

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Pulmonary Artery Pseudoaneurysm After Tube Thoracostomy

Cited by 22 publications

References 4 publications

Tube Thoracostomy: Complications and Its Management

Tube Thoracostomy: Complications and Its Management

Pulmonary artery pseudoaneurysm following blunt trauma

Embolization Techniques in Trauma of the Chest

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