Development of ARDS by Hemothorax as a Complication of Subclavian Catheter Insertion / 대한신장학회잡지

Subclavian catheters were used in the treatment of chronic renal failure patients waiting for the maturation of AV fistula. But, it sometimes causes fatal complications. Of these, massive bleeding into pleural cavity after subclavian vein cannulation is a rather rare but causes very serious complication. Most of patients with hemothorax are successfully treated with conservative treatment(i.e. pleural drainage, maintaining the circulatory volume, treatment of possible coagulopathy) but it sometimes needs surgery. We recently experienced a case of ARDS complicated by hemothorax which was successfully treated with thracooscopic drainage. We reviewed the pathogenesis of ARDS by hemothorax and suggested the guidlines for the treatment of massive hemothorax using video-assisted thoracoscopic surgery.

Retroperitoneal Abscess by Citrobacter and Klebsiella in a Renal Transpant Recipient / 대한이식학회지

Infectious complications are common causes of morbidity in renal transplant recipients. To date, only two cases of retroperitoneal abscess caused by Norcardia asteroides and Mycobacterium fortuitum were reported in renal transplant recipients in the literature. We report a case of retroperitoneal abscess caused by gram negative bacilli-Citrobacter freundi, Klebsiella pneumoniae. The patient was admitted to the hospital due to flank pain. Abdominal CT scan and CT scan-guided aspiration confirmed retroperitoneal abscess. It is likely that the abscess in our patient was related to the anti-rejection treatment which included high-dose steroids, and mycophenolate mofetil. To our knowledge, this is the first report of retroperitoneal absces caused by gram-negative bacilli.