A rare complication following internal jugular vein catheterization to malposition: acute Budd Chiari syndrome
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CASE REPORT
Open Access
A rare complication following internal jugular vein catheterization to malposition: acute Budd Chiari syndrome Sumeyra Koyuncu1* , Nevzat Herdem2, Cihan Uysal1, Guven Kahriman2, Ismail Kocyigit1, Murat Sipahioğlu1, Bulent Tokgoz1 and Oktay Oymak1
Abstract Background: Tunneled catheters can be used as an alternative vascular access in patients with limited health expectancy,vascular access problems and several comorbidities. We aimed to present a patient with venous stenosis related- reversible acute Budd-Chiari syndrome after catheter malposition. Case presentation: After changing of tunneled catheter insertion, 36-year old man was admitted to our hospital with sudden onset of nausea, fever, chills and worsening general condition In computed tomography (CT) imaging, a hypodense thrombus was observed in which the distal end of the catheter is at the level of drainage of the hepatic veins in the inferior vena cava and that blocked hepatic vein drainage around the catheter. The catheter was removed and a new catheter was inserted in the same session. Because patient’s general condition was good and without fever, he was discharged with advices on the 9th day of hospitalization. Conclusion: Although catheter malposition and thrombosis are not a common complication, clinicians should be alert of these complications. Keywords: Budd Chiari, Catheter, Hemodialysis, Malposition
Background The incidence of end stage renal disease (ESRD), which is one of the important health problems of worldwide, is gradually increasing and one of the treatment options is hemodialysis. Hemodialysis requires effective vascular access routes with a blood flow of at least 350 mL/min [1–3]. It has been suggested that the first choice for vascular access is arteriovenous fistula (AVF), but tunneled catheters can be used as an alternative to AVF in patients with limited health expectancy, comorbidities and * Correspondence: [email protected] 1 Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey Full list of author information is available at the end of the article
vascular access problems according to Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines [4]. Infection, internal jugular vein (IJV) stenosis and thrombosis are also common complications of permanent intrajugular hemodialysis catheterization [5]. Despite all complications, usage of dialysis catheter is still very common in this cohort according to the annual report of the United States Renal Data System (USRDS), approximately 63% of patients used a catheter for vascular access for the first dialysis treatment in the USA [6]. Another important complication such as catheter malposition ratio was between 3.6–14% in small and medium-sized studies in the literature. However, catheter malposition is rare in right IJV catheterization [7, 8].
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharin
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