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心包内透析导管：心脏压塞的罕见原因，强调早期诊断和处理的重要性。

Intrapericardial Dialysis Catheter: A Rare Cause of Cardiac Tamponade Emphasizing the Importance of Early Diagnosis and Management.

作者信息

Landsweerdt Simon, Bertrand Simon, Halbrecq Chloé, Gennart Thibault, Eucher Philippe

机构信息

Department of Cardiovascular and Thoracic Surgery, Mont-Godinne University Hospital, Yvoir, BEL.

Departement of Intensive Care, Mont-Godinne University Hospital, Yvoir, BEL.

出版信息

Cureus. 2025 Aug 4;17(8):e89344. doi: 10.7759/cureus.89344. eCollection 2025 Aug.

DOI:10.7759/cureus.89344
PMID:40909063
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12407027/
Abstract

We report a rare and serious case of intrapericardial malposition of a dialysis catheter in a 70-year-old patient with chronic kidney disease secondary to IgG kappa amyloidosis. The complication was initially revealed by an episode of supraventricular arrhythmia and confirmed through imaging studies. Catheter removal led to hemodynamic decompensation due to a compressive pericardial effusion, which required emergency sternotomy for drainage. The postoperative course was favorable. This case highlights the importance of thorough assessment of catheter placement and the need for prompt, multidisciplinary management in rare but potentially fatal complications of hemodialysis.

摘要

我们报告了一例罕见且严重的病例，一名70岁继发于IgG κ轻链淀粉样变性的慢性肾脏病患者，其透析导管发生心包内异位。该并发症最初由一次室上性心律失常发作揭示，并通过影像学检查得以证实。由于心包积液产生压迫，拔除导管导致血流动力学失代偿，这需要紧急开胸引流。术后病程顺利。该病例凸显了全面评估导管位置的重要性，以及对于血液透析罕见但可能致命的并发症进行迅速多学科管理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/68697127d2e0/cureus-0017-00000089344-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/4c6a798df80c/cureus-0017-00000089344-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/9e02063355bd/cureus-0017-00000089344-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/fb127ccd15bb/cureus-0017-00000089344-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/2b8e8a6334e9/cureus-0017-00000089344-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/68697127d2e0/cureus-0017-00000089344-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/4c6a798df80c/cureus-0017-00000089344-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/9e02063355bd/cureus-0017-00000089344-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/fb127ccd15bb/cureus-0017-00000089344-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/2b8e8a6334e9/cureus-0017-00000089344-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c96/12407027/68697127d2e0/cureus-0017-00000089344-i05.jpg

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本文引用的文献

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Digging Deeper to Diagnose: Cardiac Tamponade Following Tunneled Dialysis Catheter Placement.深入探究以明确诊断：隧道式透析导管置入术后的心包填塞
Cureus. 2024 Sep 27;16(9):e70317. doi: 10.7759/cureus.70317. eCollection 2024 Sep.
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Iatrogenic Cardiac Tamponade Secondary to Central Venous Catheter Placement: A Literature Review.中心静脉导管置入继发医源性心脏压塞：文献综述
Cureus. 2023 Apr 17;15(4):e37695. doi: 10.7759/cureus.37695. eCollection 2023 Apr.
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Eur Heart J Case Rep. 2021 Sep 3;5(9):ytab332. doi: 10.1093/ehjcr/ytab332. eCollection 2021 Sep.
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[Cardiac tamponade: a rare complication of central venous catheter - a clinical case report].[心脏压塞：中心静脉导管的罕见并发症——1例临床病例报告]
Braz J Anesthesiol. 2018 Jan-Feb;68(1):104-108. doi: 10.1016/j.bjan.2016.02.003. Epub 2016 Mar 22.
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