RT Journal Article
SR Electronic
T1 Bilateral Pneumothoraces Following a Right Subclavian Catheter Insertion After Thymectomy for a Patient With a Myasthenic Crisis
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 256
OP 258
VO 13
IS 2
A1 Alaa A. Abd-Elsayed
A1 Tamer Ghaly
A1 Ehab Farag
A1 Wael Ali Sakr Esa
YR 2013
UL http://www.ochsnerjournal.org/content/13/2/256.abstract
AB Background Myasthenia gravis (MG) is an autoimmune disease involving the formation of antibodies against the nicotinic acetylcholine receptors. Thymectomy is the treatment in MG patients with thymoma. We report a case of an MG patient who developed postthymectomy bilateral pneumothoraces after the placement of a subclavian central venous catheter.Case Report The 21-year-old patient with MG underwent a thymectomy and, in a later admission, complained of myasthenic crisis symptoms. He was scheduled to receive plasma exchange therapy and electromyography the following day. Plasmapheresis was initiated after the placement of a right subclavian dialysis catheter. Postinsertion chest x-ray revealed bilateral pneumothoraces after a single unilateral attempt to cannulate the right subclavian vein. A right thoracotomy tube was placed with interval resolution of the bilateral pneumothoraces.Conclusion The development of bilateral pneumothoraces in this case was attributed to the possible accidental communication between the 2 pleural spaces, which rarely happens during thymectomy surgery.