A 57-year- old female with a tracheostomy and a diagnosis of ocally advanced squamous cell carcinoma of the larynx underwent a routine cervical CT scan, which revealed an excavated pulmonary nodule in the right upper lobe, measuring 2.5 x 1.4 cm, that was suspicious for malignancy.
A biopsy was performed in an interventional suite with CT fluoroscopy capabilities. The biopsy was performed with local anesthesia and a 16/18 gauge semi-automatic coaxial core-biopsy needle. The patient was placed in the prone position.
Immediately after the needle was positioned inside the nodule, the patient presented with hemoptysis and agitation. Subsequent imaging revealed gas inside the thoracic aorta.
The patient quickly developed cardiac arrest with pulseless electrical activity, and cardiopulmonary resuscitation procedures, including norepinephrine administration, were performed. Spontaneous circulation and blood pressure stabilization occurred within approximately five minutes. The patient was then transferred to the intensive care unit, where she remained for thirteen days until discharge without any neurological sequelae.
Monday, 12 September 2016
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