Sirvent Ana E, Enríquez Ricardo, Millán Isabel, García-Marco Jose M, Rodríguez-Czaplicki Elías, Redondo-Pachón Maria D, González César, Amorós Francisco
Nephrology Section, Hospital General Universitario de Elche, Elche, Spain.
Hemodial Int. 2012 Apr;16(2):315-9. doi: 10.1111/j.1542-4758.2011.00632.x.
Mechanical complications of femoral catheterization for hemodialysis include pseudoaneurysm, arteriovenous fistulae, neurological injury, and vessel perforation. With regard to the latter, severe hemorrhage is a rare but devastating and potentially fatal complication. We report the case of a 76-year-old female who underwent femoral catheterization for hemodialysis using ultrasound guidance. The first hemodialysis session was conducted without incident. Unfortunately, inadvertent injury and delayed perforation of the iliac vein resulted in severe hemorrhage and retroperitoneal hematoma. Surgical repair was performed. The patient was asymptomatic after the procedure and was discharged 15 days later. Based on this case and a review of the literature, we present mechanisms and ways to prevent this complication.
血液透析股动脉置管的机械并发症包括假性动脉瘤、动静脉瘘、神经损伤和血管穿孔。关于后者，严重出血是一种罕见但具有毁灭性且可能致命的并发症。我们报告一例76岁女性患者，她在超声引导下接受了血液透析股动脉置管。首次血液透析过程顺利。不幸的是，髂静脉意外损伤和延迟穿孔导致严重出血和腹膜后血肿。进行了手术修复。术后患者无症状，15天后出院。基于此病例并结合文献复习，我们阐述了该并发症的发生机制及预防方法。
