Home | Volume 43 | Article number 98

Images in clinical medicine

Migration of a jugular hemodialysis catheter revealed by edema of the left upper limb

Migration of a jugular hemodialysis catheter revealed by edema of the left upper limb

Hafedh Daly1,&, Abdelbaki Bouallegue2

 

1Cardiovascular Surgery Department, Regional Hospital of Gafsa, Faculty of Medicine of Monastir, Monastir, Tunisia, 2Nephrology and Hemodialysis Department, Regional Hospital of Gafsa, Gafsa, Tunisia

 

 

&Corresponding author
Hafedh Daly, Cardiovascular Surgery Department, Regional Hospital of Gafsa, Faculty of Medicine of Monastir, Monastir, Tunisia

 

 

Image in medicine    Down

A 42-year-old patient, with chronic renal failure on dialysis for 3 years, consulted for a significant edema of the left upper limb evolving for a month. On questioning, the patient reported the breakage of the outer end of the jugular hemodialysis catheter during an attempt to remove it by himself a year ago. The physical examination found a functional left humero-basilic arteriovenous fistula and the presence of multiple small left cervical scars testifying to an iterative placement of a jugular catheters for hemodialysis. The doppler ultrasound objectived a thrombosis of the left internal jugular vein with the presence of a catheter in its lumen. The chest X-ray showed the route of the catheter which reaches the right brachiocephalic venous trunk. The patient was operated by a left cervicotomy. The surgical exploration confirmed the migration of the catheter in the left jugular vein which is sclerotic and thrombosed. It was successfully removed and the postoperative course was simple.

 

 

Figure 1: A) chest X-ray showing the route of the catheter; B) intraoperative view showing the catheter in the lumen of the left internal jugular vein; C) postoperative image of the removed catheter