Background
Tunneled catheters can be used as an alternative vascular access in patients with limited health expectancy,vascular access problems and several comorbidities. We aimed to present a patient with venous stenosis related- reversible acute Budd-Chiari syndrome after catheter malposition.
Case presentation
After changing of tunneled catheter insertion, 36-year old man was admitted to our hospital with sudden onset of nausea, fever, chills and worsening general condition In computed tomography (CT) imaging, a hypodense thrombus was observed in which the distal end of the catheter is at the level of drainage of the hepatic veins in the inferior vena cava and that blocked hepatic vein drainage around the catheter. The catheter was removed and a new catheter was inserted in the same session. Because patient’s general condition was good and without fever, he was discharged with advices on the 9th day of hospitalization.
Conclusion
Although catheter malposition and thrombosis are not a common complication, clinicians should be alert of these complications.
Background Although there are many studies on percutaneous nephrostomy in urinary obstruction management in pediatric patients, there is a limited number of studies on percutaneous antegrade ureteral stenting (PAUS) on this issue. Purpose To evaluate the results of fluoroscopy-guided percutaneous antegrade approach for ureteral stent placement through the nephrostomy route in children. Material and Methods Between October 2005 and June 2019, the medical records of children who underwent PAUS through the nephrostomy route were reviewed retrospectively. Demographic data of the patients, technical and clinical success rates, technical details, and complications of the procedure were recorded. Patients were divided and evaluated into groups according to etiology. Categorical data were analyzed by using the Pearson chi-square test. Results In total, 31 patients (19 boys, 12 girls; age range = 2 months–18 years; mean age = 7.4 ± 6.01 years) and 42 procedures were included in the study. The most common underlying diseases were ureteropelvic junction obstruction (16 stents, 38.1%) and vesicoureteral reflux (13 stents, 31%). The technical and clinical success rates were 97.6% and 90%, respectively. Clinical failure (10%) was not related to gender, underlying diseases, and stent size ( P > 0.05). Mean stent dwelling time was 96.43 ± 58.1 days. Complications were urinary tract infection (two procedures), stent migration (two procedures), early occlusion (one procedure), and contrast material leak after balloon dilation (one procedure). The complication rate was 14.6%. No procedure-related death was observed. Conclusion PAUS through the nephrostomy route in children is an effective and reliable method when surgical treatment is not feasible.
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