MULTIPLE VENOUS THROMBOSIS COMPLICATING CENTRAL VENOUS CANNULATION IN A NON CANCER PATIENT – A CASE REPORT
Department of Anaesthesia, Lagos University Teaching Hospital, Lagos.
Department of Anaesthesia Lagos University Teaching Hospital & College of Medicine, University of Lagos.
Cardiothoracic Unit, Department of Surgery, Lagos University Teaching Hospital & College of Medicine, University of Lagos.
E-Mail: ifymenkiti@hotmail.com
*Correspondence
Grant support: None
Conflict of Interest: None
ABSTRACT
Background: Central venous catheterization is a common procedure for critically ill patients. Like all procedures, it has its complications, one of which is thrombosis. Reports of thrombosis are commoner among cancer patients. We present a 37 year old non cancer patient who developed thrombi in both right and left internal jugular veins, 10 and 13 days respectively after insertion of central venous catheter. This was detected by ultrasound scans of the neck while attempting re-cannulation for parenteral feeding.
She also had left lower limb deep venous thrombosis, confirmed by doppler scan, which was managed with low molecular weight heparin and warfarin. The patient was subsequently treated with streptokinase. A repeat scan of the internal jugular veins 4 days after thrombolysis revealed a reduction in size of the thrombi. Symptoms of deep venous thrombosis improved and she was transferred to the wards where she made remarkable improvement. This case illustrates the potential usefulness of ultrasound guided-central line insertion in patients who have had central venous lines inserted previously in order to detect thrombi.
Keywords: Thrombosis, Central venous catheter, Ultrasound-guided cannulation.