Missing Guidewire in a Bulla: A Case Report
The incidence of a missing guidewire during the Seldinger technique is low but can occur due to procedural errors. Reported rates vary, ranging from 0.1% to 0.8% in central venous catheterization and other vascular access procedures. We present a rare case of a retained guidewire within a pulmona...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2025-07-01
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| Series: | Journal of Chest Surgery |
| Subjects: | |
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| Summary: | The incidence of a missing guidewire during the Seldinger technique is low but can occur
due to procedural errors. Reported rates vary, ranging from 0.1% to 0.8% in central venous
catheterization and other vascular access procedures. We present a rare case of a retained
guidewire within a pulmonary bulla following Seldinger-based chest tube insertion in a
patient with ventilator-induced pneumothorax. Due to a prolonged air leak, the guidewire
was removed, and wedge resection of the affected lung parenchyma, along with talc pleurodesis,
was performed via video-assisted thoracoscopy. Closed thoracostomy using the
Seldinger technique requires caution in emphysematous patients receiving mechanical
ventilation. To facilitate lung deflation and minimize the risk of lung injury during needle
and guidewire placement, the endotracheal tube can be temporarily disconnected from
the ventilator. Over-insertion of the wire and dilator should be avoided. Supervision and
simulation training are crucial to prevent this type of “never event.” |
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| ISSN: | 2765-1606 2765-1614 |