Bilateral hydrothorax and hydromediastinum after a subclavian line insertion.

A 28-year-old male patient developed bilateral hydrothorax due to extravasation of fluid into the mediastinum from a subclavian line. The injection of radio-opaque dye through the central venous cannula confirmed spillage into the mediastinum. There was no direct communication between the central venous cannula and the pleural cavities. The hydrothorax appeared to develop as a result of a shift of fluid from the mediastinum into the pleural cavities due to pressure differences in the two compartments. Bilateral chest tubes were inserted, the subclavian cannula was removed and the patient made a good recovery.