Tension Chylothorax as A Complication from Percutaneous Catheterization: A Case Report

中心靜脈導管置放後續發的張力性乳糜胸：病例報告

顏子傑(Zih-Jie Yan) ； 邱炳芳(Ping-Fang Chiu)

《內科學誌》 29卷5期 (2018/10) Pp. 323-326

https://doi.org/10.6314/JIMT.201810_29(5).07

摘要

Chylothorax is a rare complication of central venous catheterization. Massive chylothorax could result in respiratory failure and unstable hemodynamic status, causing high mortality. The classic appearance of chyle is milky white, but it could also show other appearances. Central venous catheterization is a common procedure in intensive care units and in patients with end-stage renal disease for undergoing hemodialysis. We report a case of a new diagnosis of microscopic polyangiitis complicated with rapidly progressive glomerulonephritis. Tension chylothorax developed after the placement of permanent catheter. After pigtail drainage of pleural effusion and supportive care, patient was stabilized. Her chylothorax had completely resolved.

關鍵字

Tension hydrothorax ； Chylothorax ； Central vein catheterization

並列摘要

乳糜胸是中心靜脈導管置放術的罕見併發症。大量乳糜胸可能導致呼吸衰竭和不穩定的血液動力學狀態，導致高死亡率。典型乳糜的外觀是乳白色，但它也可以是其他外觀。中心靜脈導管置放術是重症監護病房和末期腎病患者進行血液透析的常見手術。我們報告一例新診斷顯微性多血管炎(Microscopic polyangiitis)合併快速進行性腎炎(Rapid Progressive Glomerulonephritis)的病例，在永久性導管置入後，發生張力性乳糜胸。在豬尾巴導管引流胸腔積液和支持治療後，患者得到穩定，乳糜胸獲得改善。