Abstract:Obstruction and thrombosis of major systemic veins can occur due to indwelling central venous catheters. If obstruction of the innominate vein or superior vena cava occurs, lymphatic drainage can be impaired due to an increase in pressure in the thoracic duct and lymphatics. We describe a case where superior vena cava syndrome, chylopericardium and chylothorax occurred in a 16-year-old girl due to an indwelling central venous catheter. This was successfully treated with removal of the line, anticoagulation and… Show more
“…Congestive heart failure was ruled out. 3 Eventually, the patient was also found to have significant SVC stenosis. Balloon and stent SVC angioplasty, HD line replacement, and drainage of the pleural effusion lead to the eventual resolution of both the pleural and pericardial effusions.…”
Section: Discussionmentioning
confidence: 98%
“…Pleural and pericardial effusions may occur secondary to infectious, autoimmune disease and malignancies, and all these were ruled out. Congestive heart failure was ruled out …”
Central venous catheter is commonly utilized as a hemodialysis access in the pediatric population. Long-standing central venous catheters can be complicated by superior vena cava (SVC) stenosis and thrombosis that can rarely present as pleural effusions. We report a case of a 5-year-old boy on chronic hemodialysis who presented with combined pleural and pericardial effusions, which was secondary to catheter induced SVC stenosis. Both the pleural effusion and the pericardial effusion in this patient subsequently improved with the relief of SVC stenosis. This case report highlights the serious complications of SVC stenosis associated with long-standing central venous catheters which is an under-recognized problem in the pediatric population.
“…Congestive heart failure was ruled out. 3 Eventually, the patient was also found to have significant SVC stenosis. Balloon and stent SVC angioplasty, HD line replacement, and drainage of the pleural effusion lead to the eventual resolution of both the pleural and pericardial effusions.…”
Section: Discussionmentioning
confidence: 98%
“…Pleural and pericardial effusions may occur secondary to infectious, autoimmune disease and malignancies, and all these were ruled out. Congestive heart failure was ruled out …”
Central venous catheter is commonly utilized as a hemodialysis access in the pediatric population. Long-standing central venous catheters can be complicated by superior vena cava (SVC) stenosis and thrombosis that can rarely present as pleural effusions. We report a case of a 5-year-old boy on chronic hemodialysis who presented with combined pleural and pericardial effusions, which was secondary to catheter induced SVC stenosis. Both the pleural effusion and the pericardial effusion in this patient subsequently improved with the relief of SVC stenosis. This case report highlights the serious complications of SVC stenosis associated with long-standing central venous catheters which is an under-recognized problem in the pediatric population.
“…Postoperative chylous effusion management algorithms aimed at identifying deep venous thrombosis (DVT) have been reported; and treatment with heparinization, local/systemic thrombolytics, and thrombectomy have been utilized if DVT is identified . Sparse reports have highlighted the potential benefits of innominate vein and superior vena cava angioplasty to ameliorate chylous effusions after pacemaker implantation and extracorporeal membrane oxygenation . However, there are no data on the utility of angioplasty for left innominate vein obstruction‐associated chylothorax in children and neonates following congenital heart surgery.…”
Section: Introductionmentioning
confidence: 99%
“…10 Chylous effusion has been associated with left innominate vein obstruction and subsequent impedance to the normal thoracic duct drainage. [11][12][13][14][15][16][17] Postoperative chylous effusion management algorithms aimed at identifying deep venous thrombosis (DVT) have been reported 3,18,19 ; and treatment with heparinization, local/systemic thrombolytics, and thrombectomy Financial support for this study was provided through departmental funds.…”
Section: Introductionmentioning
confidence: 99%
“…2,3,11,20 Sparse reports have highlighted the potential benefits of innominate vein and superior vena cava angioplasty to ameliorate chylous effusions after pacemaker implantation and extracorporeal membrane oxygenation. [21][22][23][24] However, there are no data on the utility of angioplasty for left innominate vein obstruction-associated chylothorax in children and neonates following congenital heart surgery.…”
Innominate vein occlusion and stenosis associated with chylous effusion are amenable to transcatheter revascularization and/or angioplasty, consistently leading to improvement, if not full resolution of chylothorax.
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