A rare complication following internal jugular vein catheterization to malposition: acute Budd Chiari syndrome

Abstract

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.

Budd-Chiari syndrome: An unusual complication of an internal jugular tunneled dialysis catheter

“…These suggest that endothelial damage, likely propagated by neutrophilendothelial interactions in a proinflammatory milieu could also favor thrombosis in patients with AAV. 9,10 CVC malposition was also present in all the previous cases of BCS related to CVC (Table 1); mostly the tip was in the inferior vena cava, but also in the middle hepatic vein in two cases. Malposition of the central line occurs due to in time migration or dislocation related to intrathoracic pressure changes during deep breathing, cough, and formation of fibrin sheath around the tip.…”

“…These suggest that endothelial damage, likely propagated by neutrophil-endothelial interactions in a proinflammatory milieu could also favor thrombosis in patients with AAV. 9,10…”

“…Malposition of the central line occurs due to in time migration or dislocation related to intrathoracic pressure changes during deep breathing, cough, and formation of fibrin sheath around the tip. 9 CVC migration can be reduced by positioning the tip at the junction of the right atrium and the superior vena cava, which is located approximately two vertebral body units below the carina on chest X-ray. 9 In our patient we promptly replaced the catheter with a shorter one placed in the same internal jugular vein but with the tip correctly positioned.…”

“…9 CVC migration can be reduced by positioning the tip at the junction of the right atrium and the superior vena cava, which is located approximately two vertebral body units below the carina on chest X-ray. 9 In our patient we promptly replaced the catheter with a shorter one placed in the same internal jugular vein but with the tip correctly positioned.…”

The SIF protocol: A seven-step strategy to minimize complications potentially related to the insertion of femorally inserted central catheters

“…The latter location is particularly dangerous since it is associated with a very high thrombotic risk. 34,35 The most appropriate intra-procedural method of ultrasound-based verification of the presence of the tip in the ideal portion of the IVC (above the iliac veins and below the renal veins) is still to be defined. Intraprocedural and post-procedural radiological methods of tip location (fluoroscopy and x-ray of the abdomen) may be useful though they are not accurate, as they are based on relatively uncertain radiological landmarks.…”