Guzel Yasin, Avşar Mustafa Kemal, Aydoğan Burak, Doğan Ömer, Aydin Kaniye, Piskin Ferhat Can, Misirlioglu Ali Mesut, Güzel Kadir Yasin, Yaliniz Hafize, Topçuoğlu Mehmet Şah
Department of Cardiovascular Surgery, Çukurova University, Faculty of Medicine, Adana, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):103-104. doi: 10.5606/tgkdc.dergisi.2024.mep-07. eCollection 2024 Nov.
In patients with chronic kidney disease undergoing hemodialysis, dialysis catheters are frequently used to provide vascular access. However, this procedure can lead to significant complications. Retroperitoneal hematoma is a rare but potentially life-threatening complication of femoral vein catheterization. This case report discusses the surgical management of a retroperitoneal hematoma that developed after the insertion of a left femoral dialysis catheter. A 21-year-old female patient with a known history of chronic kidney disease secondary to bilateral hydronephrosis who was on hemodialysis for five years presented to the clinic. After the insertion of a left femoral dialysis catheter, the patient developed severe abdominal pain, nausea, and vomiting. Contrastenhanced computed tomography revealed that the left femoral catheter had migrated into the retroperitoneal space, forming a large hematoma. Emergency surgical intervention was performed, including the removal of the catheter, evacuation of the retroperitoneal hematoma, and repair of the external iliac vein. Additionally, the gynecology department performed surgical intervention on an ovarian cyst, and the general surgery team controlled the bleeding. The patient had an uneventful follow-up. The literature indicates that appropriate surgical intervention positively influences prognosis in such cases. Awareness of possible complications during femoral vein catheterization can prevent delays in diagnosis and improve patient survival. As demonstrated in this case report, timely surgical intervention without removing the catheter is crucial in preventing additional complications in cases of retroperitoneal hematoma.
在接受血液透析的慢性肾脏病患者中，透析导管常被用于提供血管通路。然而，该操作可能导致严重并发症。腹膜后血肿是股静脉置管罕见但可能危及生命的并发症。本病例报告讨论了一例左股静脉透析导管置入后发生的腹膜后血肿的手术治疗。一名21岁女性患者，有双侧肾积水继发慢性肾脏病病史，已接受血液透析5年，前来就诊。在置入左股静脉透析导管后，患者出现严重腹痛、恶心和呕吐。增强CT显示左股静脉导管移入腹膜后间隙，形成巨大血肿。进行了紧急手术干预，包括取出导管、清除腹膜后血肿以及修复髂外静脉。此外，妇科对一个卵巢囊肿进行了手术干预，普通外科团队控制了出血。患者随访过程顺利。文献表明，在此类病例中，适当的手术干预对预后有积极影响。认识到股静脉置管期间可能出现的并发症可防止诊断延误并提高患者生存率。如本病例报告所示，在腹膜后血肿病例中，及时进行不移除导管的手术干预对于预防额外并发症至关重要。
