scholarly journals Horner`s Syndrome after internal jugular vein catheterization: a case report.

2021 ◽  
Author(s):  
Pedro Vinicius Brito Alves ◽  
Coralia Gabrielle Vieira Silveira ◽  
Jorge Fernando de Miranda Pereira ◽  
Isabela Fonseca Risso ◽  
Paulo Eduardo Lahoz Fernandez ◽  
...  
Keyword(s):  
Intensive Care ◽  
Case Report ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Anticholinergic Drugs ◽  
Carotid Dissection ◽  
Common Procedure ◽  
Cerebral Herniation ◽  
Critical Patients

Context: Central venous catheterization of the internal jugular vein is a common procedure that can be complicated with Horner`s Syndrome, caused by a direct lesion of cervical sympathetic pathways, pneumothorax compression, or carotid dissection. This entity should be considered when assessing new anisocoria in intensive care scenarios. Case Report: We report the case of a 64-year-old woman, who presented anisocoria during an intensive care unit hospitalization. She had been admitted with severe COVID-19 and need for mechanical ventilation. Her anisocoria was more evident in the dark, with right miosis, ipsilateral semi-ptosis, and preserved photoreaction reflexes. Before the anisocoria, she had a venous catheter inserted in her right jugular vein. Further evaluation showed a right pneumothorax, which was promptly drained after the mispuncture. The cervical arterial angiotomography showed no signs of carotid dissection. Conclusion: New anisocoria in critical patients is usually associated with impairment of the parasympathetic tonus, either by the use of topic or inhalatory anticholinergic drugs or cerebral herniation syndrome. However, in these situations, the anisocoria is more appreciable in light, with disruption of photoreaction in the greater pupil and ipsilateral ptosis. Therefore, we believe our patient developed an iatrogenic Horner`s Syndrome, secondary to a catheterization mispuncture, leading to a direct lesion of sympathetic pathways and their compression by the pneumothorax. Beyond parasympathetic pharmacologic blockade or cerebral herniation, Horner`s Syndrome constitutes a valuable differential diagnosis when evaluating patients with new anisocoria in the ICU.

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.

Iatrogenic lymphocutaneous fistula secondary to right-sided pheresis catheter placement and its percutaneous treatment: a case report

2017 ◽  
Vol 18 (4) ◽  
pp. e45-e47 ◽  
Author(s):  
Keith B. Quencer ◽  
Raj R. Ayyagari ◽  
Tamir Friedman
Keyword(s):  
Case Report ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Transplant Rejection ◽  
Venous Catheter ◽  
Percutaneous Treatment ◽  
Central Venous ◽  
Cyanoacrylate Glue ◽  
Image Guided ◽  
The Right

We present a case of an iatrogenic lymphocutaneous fistula secondary to placement of a tunneled, large bore (14.5 Fr) right-sided internal jugular vein for plasmapheresis to treat antibody-mediated kidney transplant rejection. While iatrogenic lymphatic leaks caused by neck and thoracic surgeries are well described in the literature, lymphatic leak or lymphocutaneous fistula resulting from image-guided placement of a central venous catheter through the right internal jugular vein has yet to be described. We also describe the successful percutaneous treatment of this lymphocutaneous fistula using a combination of n-butyl cyanoacrylate glue and embolization coils.

scholarly journals A Study of Malposition of Central Venous Catheter – A Comparative Study between Ultrasound Guided and Anatomical Landmark Technique

2018 ◽  
Vol 2 (3) ◽  
pp. 277-281
Author(s):  
Lalit Kumar Rajbanshi ◽  
Sambhu Bahadur Karki ◽  
Batsalya Arjyal
Keyword(s):  
Real Time ◽  
Internal Jugular Vein ◽  
Subclavian Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Anatomical Landmark ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Catheter Tip ◽  
Landmark Technique

Introduction: Central venous catheterization is a routine procedure for long-term infusion therapy and central venous pressure measurement. Sometimes, the catheter tip may be unintentionally placed at the position other than the junction of superior vena cava and right atrium. This is called malposition and can lead to erroneous pressure measurement, increase risk of thrombosis, venous obstruction or other life threatening complications like pneumothorax, cardiac temponade.Objectives: This study aimed to observe the incidence of the malposition and compare the same between ultrasound guided catheterization and blind anatomical landmark technique.Methodology: This study was a prospective comparative study conducted at the intensive care unit of Birat Medical College and Teaching Hospital for two-year duration. All the catheterizations were done either with the use of real time ultrasound or blind anatomical landmark technique. The total numbers of central venous catheterization, the total incidences of malposition were observed. Finally the incidences were compared between real time ultrasound guided technique and blind anatomical landmark technique.Results: In two-year duration of the study, a total of 422 central venous cannulations were successfully done. The real time ultrasound was used for 280 cannulations while blind anatomical landmark technique was used for 162 patients. The study observed various malposition in 36 cases (8.5%). The most common malposition was observed for subclavian vein to ipsilateral internal jugular vein (33.3%) followed by subclavian to subclavian vein (27.8%) and internal jugular to ipsilateral subclavian vein (16.7%). In four patients the catheter had a reverse course in the internal jugular vein while the tip was placed in pleural cavity in three cannulations. There was coiling of the catheter inside left subclavian vein in one patient. The malposition was significantly reduced with the use of the real time ultrasound (P< 0.001). However there is no significant difference in the incidence of the various malposition between ultrasound guidance technique and blind anatomical landmark technique when compared individually.Conclusion: The malposition of the central venous catheter tip was common complication with the overall incidence of 8.5%. The most common malposition was subclavian vein to internal jugular vein. The use of real time ultrasound during the catheterization procedure can significantly reduced the risk of malposition.Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 277-281

Internal jugular vein thrombosis: an uncommon presentation

Vascular ◽  
2013 ◽  
Vol 21 (4) ◽  
pp. 267-269 ◽  
Author(s):  
Sachin Mittal ◽  
Pradeep Garg ◽  
Surender Verma ◽  
Sandeep Bhoriwal ◽  
Sourabh Aggarwal
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Sinus Thrombosis ◽  
Color Doppler ◽  
Venous Catheter ◽  
Neck Surgery ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Uncommon Presentation ◽  
Internal Jugular Vein Thrombosis

Internal jugular vein (IJV) thrombosis is a rare entity. It is usually secondary to various etiologies such as ovarian hyperstimulation, deep vein thrombosis of upper limbs, venous catheter, malignancy, trauma, infection, and neck surgery and hypercoagulable status. We report an unusual case of internal jugular vein thrombosis with cerebral sinus thrombosis, postpartum in a 22-year-old female patient who presented with a painful swelling on the left side of her neck. Diagnosis was established by color Doppler ultrasonography and magnetic resonance venography. Thorough evaluation of the patient revealed no etiological factor leading to thrombosis. Patient was treated with low-molecular-weight heparin.

scholarly journals Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

2018 ◽  
Vol 47 (2) ◽  
pp. 1005-1009
Author(s):  
Taehee Pyeon ◽  
Jeong-Yeon Hwang ◽  
HyungYoun Gong ◽  
Sang-Hyun Kwak ◽  
Joungmin Kim
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Present Report ◽  
Large Diameter ◽  
Venous Catheter ◽  
Venous Access ◽  
Central Venous ◽  
The Right ◽  
Gain Access

Central venous catheters are used for various purposes in the operating room. Generally, the use of ultrasound to insert a central venous catheter is rapid and minimally complicated. An advanced venous access (AVA) catheter is used to gain access to the pulmonary artery and facilitate fluid resuscitation through the internal jugular vein. The present report describes a case in which ultrasound was used in a 43-year-old man to avoid complications during insertion of an AVA catheter with a relatively large diameter. The sheath of the catheter was so thin that a dilator was essential to prevent it from folding upon insertion. Despite the use of ultrasound guidance, the AVA catheter sheath became folded within the patient’s internal jugular vein. Mechanical complications of central venous catheter insertion are well known, but folding of a large-bore catheter in the internal jugular vein has rarely been reported.

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