Pneumomediastinum during sexual intercourse.
نویسندگان
چکیده
In describing 500 cannulations of the internal jugular vein using their innovative technique, English et al recorded as complications one pneumothorax and three haematomas formed by entering an artery.' Other rare early complications of this or of closely related methods have subsequently been encountered, chiefly in small infants. These include pleural damage with pneumothorax, direct tracheal injury,2 infection, venous thrombosis, embolism, arterial laceration, trauma of the thoracic duct on the left side, injury to the brachial or cervical plexus, and Horner's syndrome. Late complications include cardiac tamponade and hydropneumothorax.3 Inadvertent entry into an artery occurred in three out of 316 cannulations of the internal jugular vein reported by Rao et al4 as well as in three of the original 500 cases described by English et al.1 Formation of an arteriovenous communication is well recognised after penetrating injury and is perhaps not unexpected after percutaneous insertion of a cannula. The two cases described here represent one centre's cumulative experience of cannulation procedures in more than 1000 cases over five years. Both patients had aortic valve lesions, and unfolding of the aortic arch and major arteries, which is often seen in disease of the aortic valve, may have been implicated. Arteriovenous communication may present as an early or late complication of apparently uneventful cannulation of the internal jugular vein, any latency probably being governed by the size of the artery concerned. Digital subtraction angiography is ideally suited to clarifying the anatomy of small vascular lesions of this kind. Because the use of percutaneous vein cannulation is increasing, surgeons and physicians should be aware of potential complications such as arteriovenous communication.
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ورودعنوان ژورنال:
- British medical journal
دوره 288 6425 شماره
صفحات -
تاریخ انتشار 1984