Science and Education Department, Baoding No. 1, Central Hospital, Baoding, China.
Department of Nephrology, Baoding No. 1 Central Hospital, Baoding, China.
J Pak Med Assoc. 2024 Sep;74(9):1690-1692. doi: 10.47391/JPMA.10163.
Chronic kidney disease has become a significant global health issue, with some individuals progressing to endstage renal disease (ESRD) and requiring renal replacement therapy. For ESRD patients undergoing haemodialysis, the first step is to establish vascular access. In emergency situations, inserting a haemodialysis catheter (HDC) into the central vein is often the most appropriate approach; the right internal jugular vein (IJV) is considered the optimal site for catheterisation. However, catheter placement in the right IJV can sometimes lead to inadvertent entry into an abnormal position. Herein, we present a unique case in which the tip of the HDC was noted to have misplaced into the left IJV due to the patient's multiple central venous stenosis (CVS). This case highlights the clinical manifestation of HDC misplacement, with CVS being the underlying cause. Therefore, healthcare providers should pay adequate attention to CVS.
慢性肾脏病已成为一个重大的全球健康问题,部分患者进展为终末期肾病(ESRD)并需要肾脏替代治疗。对于接受血液透析的 ESRD 患者,首先要建立血管通路。在紧急情况下,将血液透析导管(HDC)插入中心静脉通常是最合适的方法;右颈内静脉(IJV)被认为是导管插入的最佳部位。然而,右 IJV 中的导管放置有时会导致导管意外进入异常位置。在此,我们报告了一例由于患者多处中心静脉狭窄(CVS)导致 HDC 尖端错位至左 IJV 的独特病例。该病例突出了 HDC 错位的临床表现,CVS 是其根本原因。因此,医疗保健提供者应充分注意 CVS。