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双侧肺动脉钙化性纤维蛋白鞘栓塞:文献中的第二例。

Calcified Fibrin Sheath Embolism of Bilateral Pulmonary Arteries: A Second Case of the Literature.

机构信息

Department of Radiology, Selçuk University School of Medicine, Konya 42130, Turkey.

出版信息

Curr Med Imaging. 2023;19(12):1468-1471. doi: 10.2174/1573405619666230123154146.

Abstract

INTRODUCTION/BACKGROUND: Central venous catheters, which provide a unique convenience in the management of critical patients, have many advantages, as well as early and late complications. Early complications include pneumothorax, vascular perforation, hematoma formation, air embolism, or catheter malposition that may occur during or shortly after catheter insertion. Late complications include infection, venous stenosis, catheter thrombosis, and catheter tip migration. In the literature, embolization of a calcified fibrin sheath due to a central venous catheter to the pulmonary artery has been reported only in one case.

CASE PRESENTATION

The purpose of this report is to present bilateral pulmonary artery embolism in a patient who presented with cough and chest pain caused by calcified fibrin sheath of the port catheter removed before that was used for regular chemotherapeutic infusions due to liposarcoma, as the second case in the literature with imaging findings. The patient underwent medical treatment, and as a result of the treatment, symptoms regressed.

CONCLUSION

Central venous catheters have many complications, and although it is rare, pulmonary embolism is one of them. The embolism of a calcified sheath is even rare, but it is still possible. However, an embolism can cause significant morbidity and even mortality for a patient if it occurs. As physicians, we should be aware of this entity to diagnose.

摘要

简介/背景:中心静脉导管在危重症患者的管理中提供了独特的便利,具有许多优点,但也存在早期和晚期并发症。早期并发症包括气胸、血管穿孔、血肿形成、空气栓塞或导管位置不当,这些可能发生在导管插入过程中或之后不久。晚期并发症包括感染、静脉狭窄、导管血栓形成和导管尖端迁移。在文献中,仅报道过一例因中心静脉导管钙化纤维鞘而栓塞至肺动脉的病例。

病例介绍

本报告的目的是介绍一例因脂肪肉瘤而接受常规化疗输注的端口导管钙化纤维鞘脱落导致咳嗽和胸痛的患者出现双侧肺动脉栓塞,这是文献中的第二例有影像学发现的病例。患者接受了药物治疗,治疗后症状缓解。

结论

中心静脉导管有许多并发症,虽然罕见,但肺栓塞是其中之一。钙化鞘的栓塞甚至更为罕见,但仍然有可能发生。然而,如果发生栓塞,可能会对患者的发病率甚至死亡率产生重大影响。作为医生,我们应该意识到这种实体以进行诊断。

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