DOI: https://doi.org/10.36347/sjmcr.2025.v13i01.008

Pages: 50-52

Introduction: Pneumothorax is one of the unfortunate mechanical complications of central venous catheter placement in chronic end-stage renal failure. Clinically, it manifests itself by sudden pain located on one side of the thorax, a dry irritative cough that increases the pain. The aim of our work was to describe the clinical, paraclinical and therapeutic aspects of pneumothorax in hemodialysis patients. Observation: It was a male subject, 56 years old, non-insulin-dependent diabetic and hypertensive under treatment. For two years he had been followed for renal failure. The patient was hospitalized in the medical emergency department for disorders of consciousness. The biological assessment found a urinary tract infection with decompensated diabetes, terminal renal failure. The patient was put on antibiotic treatment then transferred to nephrology for management. The indication for emergency dialysis was made in view of acute pulmonary edema requiring the placement of a central catheter in the right jugular vein. After two dialysis sessions, the patient presented with sudden pain located on the right side of the chest, a dry irritating cough which increased the pain, moderate dyspnea and insomnia. The clinical examination found an altered patient, poorly colored, afebrile with a blood pressure of 117/110, heart rate of 101 beats per minute, respiratory rate of 23 cycles per minute, subcutaneous emphysema occupying the neck and thorax. The chest X-ray showed diffuse subcutaneous emphysema of the neck and thorax with low-abundance right pneumothorax. The evolution was favorable with resolution of symptoms after removal of the central venous catheter. Conclusion: Catheter placement is not a trivial procedure because patients who benefit from it may develop a complication such as pneumothorax. The risk is greater for patients with extreme body mass. Echo-guided internal jugular placement considerably reduces this risk.