Harrison Elizabeth, Lal Simon
Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, UK.
BMJ Case Rep. 2012 Nov 21;2012:bcr2012007249. doi: 10.1136/bcr-2012-007249.
Tunnelled central venous catheters are commonly used for a variety of indications, including home parenteral nutrition, but are rarely associated with fracture and embolisation; the risk of embolisation is reported to be greater with catheters placed via the subclavian vein rather than the internal jugular route. We report the case of a 64-year-old woman with type 3 (chronic and irreversible) intestinal failure who presented with pain and swelling on infusion of parenteral nutrition through her internal jugular catheter. A chest x-ray showed fracture and embolisation of her catheter into the right ventricle. The embolised portion was retrieved and removed via the femoral route, without complication and the catheter replaced. We discuss causes of line embolisation, and highlight the possibility of embolisation occurring with an internal jugular catheter.
隧道式中心静脉导管常用于多种适应证，包括家庭肠外营养，但很少发生断裂和栓塞；据报道，经锁骨下静脉置管发生栓塞的风险高于经颈内静脉置管。我们报告一例64岁患有3型（慢性且不可逆）肠衰竭的女性患者，她在通过颈内静脉导管输注肠外营养时出现疼痛和肿胀。胸部X线显示导管在右心室发生断裂和栓塞。通过股静脉途径取出并移除了栓塞部分，未发生并发症，随后更换了导管。我们讨论了导管栓塞的原因，并强调了颈内静脉导管发生栓塞的可能性。
