Retroperitoneal Hemorrhage Following Trauma During Femoral Vein Cannulation for Hemodialysis—A Therapeutic Dilemma

Abstract

A 16-year-old male with acute renal failure developed traumatic retroperitoneal hemorrhage following femoral vein cannulation for hemodialysis. Ultrasonographic imaging accurately delineated the extent of the hematoma, However, the site of the leak could not be identified at surgery and the patient could not be saved.

Severe hemorrhage because of delayed iliac vein rupture after dialysis catheter placement: Is it preventable?

“…and the characteristics of the current hemodialysis population (advanced age, obesity) . The large caliber of the catheters required to obtain adequate flow during hemodialysis is an additional factor that must be taken into consideration, particularly in women with possible smaller vessel lumen . In addition, anatomical variations, malposition and/or migration of the catheter outside the vascular bed must be taken into account .…”

“…Of the 1083 femoral catheterizations carried out in our hospital in 15 years, this is the first case documented. In recent decades, this complication appears to be reported from isolated cases (Table ) . In different studies, ultrasound localization and visualization of the vein with respect to the artery reduces the time of exposure to risk and the number of punctures .…”

“…2 The large caliber of the catheters required to obtain adequate flow during hemodialysis is an additional factor that must be taken into consideration, particularly in women with possible smaller vessel lumen. [2][3][4][5] In addition, anatomical variations, malposition and/or migration of the catheter outside the vascular bed must be taken into account. 13 Use of heparin during the hemodialysis session and priming of catheters with anticoagulant should also be considered.…”

“…Venous access in the thigh helps to prevent the potential risks of pneumothorax, hemothorax, cardiac arrhythmia, and pericardial tamponade . However, femoral catheter cannulation and use during dialysis sessions can result in potentially severe and even fatal complications . Recently, the use of ultrasound guidance for vein cannulation has significantly improved the success rate and decreased the incidence of complications during catheter insertion .…”

“…2 However, femoral catheter cannulation and use during dialysis sessions can result in potentially severe and even fatal complications. [3][4][5] Recently, the use of ultrasound guidance for vein cannulation has significantly improved the success rate and decreased the incidence of complications during catheter insertion. [6][7][8] We describe a case of iliac vein perforation with iliac fossa hemorrhage resulting from femoral vein catheterization during hemodialysis with ultrasound guidance.…”