Acute mediastinitis secondary to delayed vascular injury by a central venous catheter and total parenteral nutrition
변경조, 김은정, 윤지영, 윤석현, Woo Ni-Na, 김철홍,
소속 상세정보
변경조 ( Byeon Gyeong-Jo ) - Pusan National University Yangsan Hospital Department of Anesthesia and Pain Medicine
김은정 ( Kim Eun-Jung ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
윤지영 ( Yoon Ji-Young ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
윤석현 ( Yoon Seok-Hyun ) - Pusan National University Yangsan Hospital Department of Anesthesia and Pain Medicine
( Woo Ni-Na ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
김철홍 ( Kim Cheul-Hong ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
KMID : 0980320150150010031
Abstract
Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.
키워드
Central venous catheter; Mediastinitis; Total parenteral nutrition; Vascular injury
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