International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes ABSTRACTIntroduction: Difficulties and complications associated with intubation are among the leading causes of surgery-related mortality in patients with obesity and obstructive sleep apnea. It is known that during perioperative intubations, the progression of the bougie may lead to serious injury and even rupturing in the trachea. Case Report: A 46-year-old ASA II patient was assessed preoperatively for uvuloplasty. His body mass index was 34.7. Preparation was completed for the difficult intubation. The patient could not directly intubated with laryngoscopy but was intubated with bougie in the second trial. After the surgery 200 mg bridion was administered and the patient was extubated. He was then followed-up in PACU. Due to the stridor, it was thought that there was edema in his upper airway. At 45 minutes of PACU follow-up, it was noticed that upper airway edema regressed but there was subcutaneous emphysema giving a sense of rattle during palpation in the periphery of the right eye. It spread rapidly over the face. Afterwards he was intubated again through video laryngoscopy due to the risk of upper airway obstruction. Fiber optic examination and thorax tomography revealed that the fistula line was on the left lateral wall following cricoid cartilage. Mucosal damage of the patient healed spontaneously and weaning was conducted three days later in the ICU. Conclusion: It was reported that tracheal injury and rupture occurs due to 'blind' advancement of the bougie during intubation. Due to the identification of subcutaneous emphysema at 45 minutes during follow-up, it was thought that the bougie caused injury in the patient. The close long-term postoperative follow-up is important in cases where difficult intubation is conducted with bougie and intubation is achieved through multiple trials.
GİRİŞYenidoğan sepsisi terimi, yaşamın ilk ayında bakteriyeminin eşlik ettiği, sistemik bulguların olduğu akut bir hastalık tablosudur (1,2) . İnsidansının her 1000 canlı doğumda 1 ile 8 arasında olduğu bildirilmektedir (1,3) . Yeni antibiyotik ve destekleyici tedavi yöntemle-rine rağmen, % 13-50 gibi mortalite oranıyla ciddi bir sorun olmaya devam etmektedir (2,4) .
Central venous cannulation through femoral veins is known to be associated with various complications. Early complications include extravasation and collection of blood, fluid, and/or contrast material in the retroperitoneal spaces or the peritoneal cavity, whereas late complications include abdominal compartment syndrome (ACS). A 30-year-old patient was admitted to the emergency department and brought into the operating room with a preliminary diagnosis of pelvic fracture and acute abdomen. An intravenous catheter was placed into the peripheral vein and a central venous catheter in the femoral vein, in the emergency room through which blood was transfused. At the start of the operation, it was found that intraperitoneal bleeding was caused by a perforation associated with the femoral catheter. We conclude that in the case of acute abdomen, if the femoral venous catheter was already placed in the emergency room, proper placement should be confirmed with ultrasound imaging. Key words: Central venous catheterization; Femoral vein; Complications; Acute abdomen; Ultrasound imaging; Emergency care Citation: Piskinel Y, Sahap M, Balci CA, Gulec H, Erkilic E, But A. Femoral venous catheter: intraperitoneal placement. Anaesth. pain intensive care 2021;25(2):203-205. DOI: 10.35975/apic.v25i2.1466 Received: 23 November 2020. Reviewed: 10 February 2021, Accepted: 1 February 2021
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