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ARTERIOVENOUS ANEURYSM OF THE PHRENIC VESSELS:  Report of a Case Following Thoracentesis

DANIEL C. ELKIN, M.D.
JAMA. 1949;141(8):531-532. doi:10.1001/jama.1949.62910080005009.
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Previous reports have dealt with instances of aneurysm and arteriovenous fistula following surgical procedures.1 This report concerns an arteriovenous fistula caused by injury of the phrenic vessels by a needle used for thoracentesis. Since to my knowledge there is no other case of this kind in the literature, it is reported because of its rarity and to point out the possibility of this injury from an accepted and frequently practiced surgical procedure.2

REPORT OF CASE  B. M. B., a woman physician aged 39, gave a history of pleural effusion at the age of 15, for which thoracentesis was performed. The needle was introduced on several occasions, always through the lower posterior portion of the right side of the chest. Tuberculosis was suspected but could not be proved bacteriologically; recovery after the withdrawal of fluid was rapid and uneventful. In 1927, in the course of a physical examination, a

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