J Thorac Cardiovasc Surg 2009;137:1023-1024
© 2009 The American Association for Thoracic Surgery
a Wessex Cardiothoracic Unit, Southampton General Hospital, Southampton, United Kingdom
b Wessex Cardiothoracic Radiology, Southampton General Hospital, Southampton, United Kingdom
Received for publication February 24, 2008; revisions received March 19, 2008; accepted for publication March 21, 2008. * Address for reprints: Sanjay Asopa, MRCS, Wessex Cardiothoracic Unit, Southampton General Hospital, Tremona Rd, Southampton, SO16 6YD United Kingdom. (Email: firstname.lastname@example.org).
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This case report highlights the importance of surface anatomy and the potential complications of using a Bonanno. Catheter as a chest drain.
An 82-year-old man presented with symptoms of increasing shortness of breath on exertion and nonproductive cough for more than a month. On examination, he had a respiratory rate of 20 breaths/min, dull percussion note, and decreased air entry in the left hemithorax. The rest of the examination was normal. The results of laboratory investigations were normal. Chest radiographic analysis demonstrated a large left-sided pleural effusion. A pleural tap was undertaken, and 20 mL of straw-colored pleural fluid was sent for histocytologic and microbiologic analysis.
A Bonanno 14-gauge catheter (Becton-Dickinson) was inserted in the left chest; there was pulsatile hemorrhage at the distal end of the catheter. Accidental perforation of an intrathoracic structure was suspected, and the catheter was immediately clamped. An emergency computed tomographic scan (
Figure 1) of the chest was undertaken, which demonstrated the tip of the
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