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KMID : 0980320150150010031
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Journal of Dental Anesthesia and Pain Medicine
2015 Volume.15 No. 1 p.31 ~ p.34
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Acute mediastinitis secondary to delayed vascular injury by a central venous catheter and total parenteral nutrition
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Byeon Gyeong-Jo
Kim Eun-Jung
Yoon Ji-Young
Yoon Seok-Hyun
Woo Ni-Na
Kim Cheul-Hong
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Abstract
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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.
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KEYWORD
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Central venous catheter, Mediastinitis, Total parenteral nutrition, Vascular injury
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