Management of venous perforation during central venous catheterization in hemodialysis patients: Three case reports
| Autor: | Man-Man Liu, Lu Chen, Li-Yun Xu, Feng Qi, Sha-Sha Wang, De-Jun Chen |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Catheterization Central Venous medicine.medical_treatment Perforation (oil well) Hemodialysis Catheter complication digital subtraction angiography central venous catheterization 03 medical and health sciences 0302 clinical medicine Renal Dialysis medicine Central Venous Catheters Humans 030212 general & internal medicine Clinical Case Report Vein Aged 80 and over medicine.diagnostic_test business.industry Angiography Digital Subtraction General Medicine medicine.disease Hemothorax Surgery Catheter medicine.anatomical_structure Pneumothorax 030220 oncology & carcinogenesis Angiography Hemodialysis Jugular Veins business venous perforation Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 |
| Popis: | Rationale: In recent years, central venous catheterization (CVC) has become widely used for hemodialysis patients. Based on 3 cases, we discussed the detection and management of venous perforation at an early stage. Patients concerns: Patients 1 (male, 77 years), 2 (male, 82 years), and 3 (male, 30 years) were diagnosed with uremia and underwent hemodialysis. Diagnoses: Computed tomography suggested pneumomediastinum in patient 1 and pneumothorax in patient 2 after a replacement of the temporary hemodialysis catheter. In patient 3, X-ray suggested that the tip of the catheter was approximately at the plane of the fifth thoracic vertebrate after the temporary catheter was placed. Interventions: In patients 1 and 2, the catheters were maintained where they were for about 2 weeks until a false lumen formed outside the catheter. In patient 3, the catheter was withdrawn at once when vein perforation was observed. Outcome: In patients 1 and 2, the catheters were adjusted successfully under digital subtraction angiography (DSA) guidance 2 weeks later. In patient 3, hemothorax developed, and a total of approximately 1000 mL of bloody fluid was drained. Lessons: When venous perforation occurs during CVC, it is safer and more reliable to adjust or withdraw the catheter under DSA guidance after a false lumen forms outside the catheter. |
| Databáze: | OpenAIRE |
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