Thoracentesis

Thoracentesis
Chest X-ray showing a left-sided pleural effusion (right side of image). This can be treated with thoracentesis.
ICD-9-CM34.91
Other codesOPCS-4.2T12.3
MedlinePlus003420

Thoracentesis /ˌθɔːrəsɪnˈtiːsɪs/, also known as thoracocentesis (from Greek θώραξ (thōrax, GEN thōrakos) 'chest, thorax' and κέντησις (kentēsis) 'pricking, puncture'), pleural tap, needle thoracostomy, or needle decompression (often used term), is an invasive medical procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes. A cannula, or hollow needle, is carefully introduced into the thorax, generally after administration of local anesthesia. The procedure was first performed by Morrill Wyman in 1850 and then described by Henry Ingersoll Bowditch in 1852.[1]

The recommended location varies depending upon the source. Some sources recommend the midaxillary line, in the eighth, ninth, or tenth intercostal space.[2] Whenever possible, the procedure should be performed under ultrasound guidance, which has shown to reduce complications.[3][4][5]

Tension pneumothorax is a medical emergency that requires needle decompression before a chest tube is placed.[6][7]

  1. ^ Kelly, Howard A.; Burrage, Walter L. (eds.). "Wyman, Morrill" . American Medical Biographies . Baltimore: The Norman, Remington Company.
  2. ^ "Human Gross Anatomy". Archived from the original on 2008-02-14. Retrieved 2007-10-22.
  3. ^ Gordon, Craig E.; Feller-Kopman, D; Balk, EM; Smetana, GW (22 February 2010). "Pneumothorax Following Thoracentesis". Archives of Internal Medicine. 170 (4): 332–9. doi:10.1001/archinternmed.2009.548. PMID 20177035.
  4. ^ Feller-Kopman, David (July 2007). "Therapeutic thoracentesis: the role of ultrasound and pleural manometry". Current Opinion in Pulmonary Medicine. 13 (4): 312–318. doi:10.1097/MCP.0b013e3281214492. PMID 17534178. S2CID 21367134.
  5. ^ Daniels, Craig E; Ryu, Jay H (July 2011). "Improving the safety of thoracentesis". Current Opinion in Pulmonary Medicine. 17 (4): 232–236. doi:10.1097/MCP.0b013e328345160b. PMID 21346571. S2CID 25046432.
  6. ^ Harcke, HT; Mabry, RL; Mazuchowski, EL (2013). "Needle thoracentesis decompression: observations from postmortem computed tomography and autopsy". Journal of Special Operations Medicine. 13 (4): 53–8. doi:10.55460/FWAO-F36G. PMID 24227562.
  7. ^ Ball, Chad G.; Wyrzykowski, Amy D.; Kirkpatrick, Andrew W.; Dente, Christopher J.; Nicholas, Jeffrey M.; Salomone, Jeffrey P.; Rozycki, Grace S.; Kortbeek, John B.; Feliciano, David V. (2010). "Thoracic needle decompression for tension pneumothorax: clinical correlation with catheter length". Canadian Journal of Surgery. 53 (3): 184–188. PMC 2878990. PMID 20507791.