Anatomy Revisited: Hemodialysis Catheter Malposition into the Chest

2018 ◽  
Vol 47 (1-3) ◽  
pp. 58-61
Author(s):  
Pan Xie ◽  
Kanfu Peng ◽  
Keqin Zhang ◽  
Hongwen Zhao ◽  
Yuxiu Sheng ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Chronic Hemodialysis ◽  
Catheter Position ◽  
Cross Sectional ◽  
Hemodialysis Catheter ◽  
Catheter Tip ◽  
And Migration ◽  
Wall Perforation ◽  
The Right

In most situations, central catheters are implanted in the right jugular vein as initial access for hemodialysis. However, after repeated punctures, the proximal vessels become stenosed and thrombosed and misplacement is likely to occur. Correct catheter position in the vein can be easily ascertained with X-ray or cross-sectional CT imaging. In this report, we describe the case of a 77-year-old patient on chronic hemodialysis via catheter due to arteriovenous fistula dysfunction. We placed a cuffed-tunneled hemodialysis catheter in the left internal jugular vein. Malpositioning of the catheter led to perforation of the great veins and migration of the catheter tip into the chest. It is important to be aware of the risk of potential incorrect positioning of dialysis catheters. Due to the stenosis and fragility of the vessel wall, perforation may occur. In cases of doubt, correct placement of large-bore catheters via the internal jugular vein should be verified by means of appropriate imaging before hemodialysis is performed.

Massive hemoptysis following cannulation of right internal jugular vein for insertion of cuffed hemodialysis catheter: A rare complication of central venous catheterization

2020 ◽  
pp. 112972982091030
Author(s):  
Hamed Ghoddusi Johari ◽  
Mohammad Mehdi Lashkarizadeh ◽  
Parviz Mardani ◽  
Reza Shahriarirad
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Main Bronchus ◽  
Rare Complication ◽  
Posterior Mediastinum ◽  
Chest Roentgenogram ◽  
Massive Hemoptysis ◽  
Rare Presentation ◽  
Hemodialysis Catheter ◽  
The Right

Here we report an extremely rare presentation of internal jugular vein catheterization, presenting as massive hemoptysis which was noted during right internal jugular vein cuffed hemodialysis catheter insertion of a 39-year-old man known-case of End-Stage Renal Disease. Chest roentgenogram and computerized tomography scan showed pleural effusion and misplacement of the tip of hemodialysis catheter in the posterior mediastinum causing possible damage to the right main bronchus. After chest tube insertion and removing the misplaced hemodialysis catheter, a proper cuffed catheter was inserted and the patient was discharged with an uneventful post-op course.

scholarly journals The Influence of the Univent® Endotracheal Tube on Internal Jugular Vein Cannulation

2005 ◽  
Vol 33 (1) ◽  
pp. 82-86 ◽  
Author(s):  
W. Schummer ◽  
C. Schummer ◽  
R. Frober ◽  
J. Fuchs ◽  
M. Simon ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Endotracheal Tube ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Clinical Investigation ◽  
Lateral Displacement ◽  
Left Internal Jugular Vein ◽  
Jugular Veins ◽  
Cross Sectional ◽  
The Right

This prospective clinical investigation assessed the effect of placement of a Univent® tube on the anatomy of the internal jugular veins and the success of cannulation of the left internal jugular vein. After obtaining informed consent, 48 adult patients were enrolled. Of these, 42 patients were eligible and were divided into two groups: Univent® tube (group U, n=21) and wire enforced endotracheal tube (group C, n=21). The Univent® tube group were having a left thoracotomy. Using horizontal ultrasound scans just above the thyroid gland, the internal jugular vein was visualized and measured before and after Univent® placement. The number of needle passes necessary to cannulate the left internal jugular vein in the two groups was also compared. Univent® tubes were associated with lateral displacement of the right carotid artery and internal jugular vein on the convex side of the Univent® tube, with compression of the right internal jugular vein by the artery, resulting in a kidney-shaped cross-section of the vein. On the left (concave side of the tube), the neck was indented, the sheath of the left carotid artery was displaced medially, and the left internal jugular vein distorted to an ellipse. There was a significant increase in the lateral diameter and a decrease in the cross-sectional area of the left internal jugular vein (t-test, P<0.05). The first attempt at cannulation of the left internal jugular vein failed significantly more often in the Univent® group (13/21 vs 5/21 in group C, Chi-square 6.22, P=0.025). Cannulation of the internal jugular vein before placement of the Univent® tube, or placement with ultrasound guidance is suggested.

Variations in the Structure of the Jugular Foramen of Human Skull

2013 ◽  
Vol 10 (2) ◽  
pp. 45-49 ◽  
Author(s):  
SM Akram Hossain ◽  
SM Moshadeq Hossain ◽  
Fakhrul Amin Mohammad Hasanul Banna
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Jugular Foramen ◽  
Jugular Bulb ◽  
Cross Sectional ◽  
Medical College ◽  
Geographical Variations ◽  
Pass Through ◽  
The Right ◽  
Study Type

Context: The jugular foramen is one of the most fascinating foramen present at the base of the skull attracting the imagination of many Anatomists worldwide as many important structures pass through it, and amongst them the intriguing structure is the internal jugular vein. The shape and size of the jugular foramen is related to the size of the internal jugular vein and the presence or absence of a prominent superior bulb. As most of the textbooks of Anatomy describe that the right jugular foramen is usually larger than the left jugular foramen. Henceforth the present study was undertaken in 55 skulls from the dept. of Anatomy. Measurements were taken with the help of sliding vernier caliper. Study type: Cross-sectional descriptive type. Place and period of study: Department of Anatomy, Rajshahi Medical College, Rajshahi and Pabna Medical College, Pabna from April 2010 to June 2011. Materials and Methods: Total fifty five (55) human adult skulls were collected from the Anatomy department of Rajshahi Medical College, Rajshahi and Pabna Medical College, Pabna at different times of the study period. The study was conducted to observe variations in the structure of the jugular foramen of the human’s skull. Result: Out of 55 skulls (110 foramina) studied, the presence of dome indicating the presence of jugular bulb was found bilaterally in 100% of cases. 58.18% of cases showed that the size of right foramina were larger than the left foramina whereas 20% of cases showed that right foramina were equal to the left and in 21.82% of cases the left foramina were larger than the right side foramina. An important observation in the present study was the presence of either complete or partial septation in the jugular foramen. Conclusion: The findings of the study reveals that there are some differences among some parameters. The variations are might be due to the geographical variations of the skeletons. It needs further study with larger sample size from different geographical areas of Bangladesh. DOI: http://dx.doi.org/10.3329/bja.v10i2.17281 Bangladesh Journal of Anatomy, July 2012, Vol. 10 No. 2 pp 45-49

Trendelenburg position for internal jugular vein catheterization: A systematic review and meta-analysis

2021 ◽  
pp. 112972982110313
Author(s):  
Mariana Garcia-Leal ◽  
Santos Guzman-Lopez ◽  
Adrian Manuel Verdines-Perez ◽  
Humberto de Leon-Gutierrez ◽  
Bernardo Alfonso Fernandez-Rodarte ◽  
...  
Keyword(s):  
Systematic Review ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Meta Analysis ◽  
Trendelenburg Position ◽  
Cross Sectional ◽  
Cross Section Area ◽  
Section Area ◽  
Internal Jugular Vein Catheterization ◽  
The Right

To determine the effect of Trendelenburg position on the diameter or cross-section area of the internal jugular vein (IJV) a systematic review and metanalysis was performed. Studies that evaluated the cross-sectional area (CSA) and anteroposterior (AP) diameter of the right internal jugular vein (RIJV) with ultrasonography in supine and any degree of head-down tilt (Trendelenburg position) were analyzed. A total of 22 articles (613 study subjects) were included. A >5° Trendelenburg position statistically increases RIJV CSA and AP diameter. Further inclination from 10° does not statistically benefit IJV size. This position should be recommended for CVC placement, when patient conditions allow it, and US-guided cannulation is not available.

Acute upper limb ischemia as a complication of tunneled hemodialysis catheter placement via the right internal jugular vein

2021 ◽  
pp. 112972982110150
Author(s):  
Ahmet Can Topcu
Keyword(s):  
Internal Jugular Vein ◽  
Upper Limb ◽  
Jugular Vein ◽  
Present Report ◽  
Limb Ischemia ◽  
Internal Jugular Vein Cannulation ◽  
Av Fistula ◽  
Hemodialysis Catheter ◽  
Vein Cannulation ◽  
The Right

Arterial injury during internal jugular vein cannulation can cause devastating complications such as stroke, hematoma, hemothorax, pseudoaneurysm, AV fistula, or even death. Acute upper limb ischemia caused by inadvertent arterial puncture during internal jugular vein cannulation has been rarely reported. The present report describes the case of a patient who experienced right upper limb ischemia caused by subclavian artery thrombosis developed during attempted placement of a tunneled hemodialysis catheter via the right internal jugular vein. The patient underwent an emergency brachial embolectomy and recovered uneventfully.

scholarly journals Effects of incrementally increasing tidal volume on the cross-sectional area of the right internal jugular vein

2013 ◽  
Vol 65 (4) ◽  
pp. 312 ◽  
Author(s):  
Youn Yi Jo ◽  
Hong Soon Kim ◽  
Mi Geum Lee ◽  
Dong Young Kim ◽  
Hae Keum Kil
Keyword(s):  
Tidal Volume ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Cross ◽  
The Right

scholarly journals Lancisi’s sign and central venous catheter tip position: a case report

2018 ◽  
Vol 19 (1) ◽  
pp. 92-93
Author(s):  
Valentina Vigo ◽  
Piero Lisi ◽  
Giuseppe Galgano ◽  
Carlo Lomonte
Keyword(s):  
Case Report ◽  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip ◽  
Tip Position ◽  
The Right ◽  
Venous Pulse

Introduction: Valvular disease and pulmonary hypertension are common conditions in haemodialysis patients. In presence of tricuspid regurgitation, an increased retrograde blood flow into the right atrium during ventricle systole results in a typical modification of the normal venous waveform, creating a giant c-v wave. This condition clinically appears as a venous palpable pulsation within the internal jugular vein, also known as Lancisi’s sign. Case report: An 83-year-old woman underwent haemodialysis for 9 years. After arteriovenous fistula thrombosis, a right internal jugular vein non-tunnelled central venous catheter (CVC) was placed. About one month later, the patient was referred to our facility for the placement of a tunnelled CVC. Neck examination revealed an elevated jugular venous pulse, the Lancisi’s sign. Surprisingly, chest x-ray posteroanterior view showed the non-tunnelled catheter tip in correspondence with the right ventricle. She underwent surgery for temporary to tunnelled CVC conversion using the same venous insertion site (Bellcath®10Fr-length 25 cm to Mahurkar®13.5Fr-length 19 cm). In the postoperative period, we observed a significant reduction of the jugular venous pulse. Discussion: The inappropriate placement of a 25-cm temporary CVC in the right internal jugular vein worsened the tricuspid valve regurgitation, which became evident by the Lancisi’s sign. Removal of the temporary CVC from the right ventricle resulted in improved right cardiac function. Safe approaches recommended by guidelines for the CVC insertion technique and for checking the tip position should be applied in order to avoid complications.

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