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May 22, 1967

Intercostal Neurectomy Complicating Needle Biopsy

Author Affiliations

USAF San Francisco

JAMA. 1967;200(8):728. doi:10.1001/jama.1967.03120210114029

To the Editor:—  Needle biopsy of the pleura has become widely accepted as a valuable procedure in the diagnosis of the etiology of many pleural effusions.1,2 At this hospital, an Abram's needle3 is customarily employed to take samples of the parietal pleura for histological and cultural examinations on the initial thoracenteses of patients with undiagnosed pleural effusions. This procedure is considered very safe, but occasionally complications of pneumothorax,4 hemorrhage into the pleural space,5 or temporary pain due to intercostal-nerve injury have occurred. However, in a patient recently seen at this hospital, incidental removal of a long segment of intercostal nerve occurred during an attempted needle pleural biopsy. To our knowledge, this is the first reported incidence of such a complication.

Report of a Case:—  A 64-year-old white man (LGH-7606-023) was admitted to Letterman General Hospital on Oct 29, 1965. He had a recurrent pleural effusion on