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Case Reports
. 2013 Summer;13(2):256-8.

Bilateral pneumothoraces following a right subclavian catheter insertion after thymectomy for a patient with a myasthenic crisis

Alaa A Abd-Elsayed  1 , Tamer Ghaly, Ehab Farag, Wael Ali Sakr Esa
Affiliations
Case Reports

Bilateral pneumothoraces following a right subclavian catheter insertion after thymectomy for a patient with a myasthenic crisis

Alaa A Abd-Elsayed et al. Ochsner J. 2013 Summer.

Abstract

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.

Keywords: Central venous catheters; chest tubes; myasthenia gravis; pneumothorax.

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Conflict of interest statement

The authors have no financial or proprietary interest in the subject matter of this article.

Figures

Figure.
Figure.
Chest x-ray showing bilateral pneumothoraces.
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