Akturk Yeliz, Ozbal Gunes Serra, Akturk Okan Murat, Akcalar Seray, Hekimoglu Baki
Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Department of Surgery, Van Training and Research Hospital, Van, Turkey.
Hemodial Int. 2016 Apr;20(2):E18-20. doi: 10.1111/hdi.12381. Epub 2015 Nov 9.
Hemodialysis catheters are vital for chronic renal failure patients. Permanent tunneled dialysis catheters may be inserted through the jugular, subclavian, and femoral veins. In this paper, we aimed to present the computed tomography findings of a chronic renal failure patient who had referred our clinic with abdominal pain and dyspnea symptoms. This patient had a formerly inserted hemodialysis catheter for chronic renal failure and her catheter was found to be extending towards the middle hepatic vein with the tip leaning onto the parenchyma. Hemodialysis catheters can provide instant vascular access and can also be used for the consecutive procedures. Permanent hemodialysis catheters are ideal for long-term use when placing an arteriovenous fistula is contraindicated or is no longer possible under conditions like advanced heart failure, peripheral artery disease or short life expectancy. The internal jugular, subclavian, the femoral veins, and the inferior vena cava can be used for catheter insertion. The tip of the catheters inserted in the neck or the thorax must extend to the vena cava superior. Catheter malposition may both lead to fatal outcomes and ineffective dialysis. It is important to obtain chest X-rays after the procedure, particularly to detect catheter malposition.
血液透析导管对慢性肾衰竭患者至关重要。永久性带隧道透析导管可通过颈静脉、锁骨下静脉和股静脉插入。在本文中，我们旨在呈现一名因腹痛和呼吸困难症状转诊至我们诊所的慢性肾衰竭患者的计算机断层扫描结果。该患者曾因慢性肾衰竭插入过血液透析导管，发现其导管向肝中静脉延伸，尖端靠在实质组织上。血液透析导管可提供即时血管通路，也可用于后续操作。当存在诸如晚期心力衰竭、外周动脉疾病或预期寿命较短等情况，放置动静脉内瘘禁忌或不再可行时，永久性血液透析导管非常适合长期使用。颈内静脉、锁骨下静脉、股静脉和下腔静脉均可用于导管插入。插入颈部或胸部的导管尖端必须延伸至上腔静脉。导管位置不当可能导致致命后果和透析无效。术后进行胸部X光检查很重要，尤其是为了检测导管位置不当。
