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Hsuan-Wei Chen1, Jin-Shuen Chen

  • 1Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, China.

Hemodialysis International. International Symposium on Home Hemodialysis
|February 7, 2012
PubMed

Insights

A misplaced double lumen catheter (DLC) in a hemodialysis patient

Area of Science:

  • Nephrology
  • Radiology
  • Vascular Surgery

Background:

  • Vascular access is crucial for hemodialysis (HD).
  • Double lumen catheters (DLCs) are temporary vascular access devices.
  • Complications can arise from improper DLC insertion and placement.

Observation:

  • A cirrhotic patient undergoing HD had a DLC inserted via the left femoral vein.
  • An incidental imaging finding revealed an unusual DLC position, suggesting iliac vessel perforation.
  • Venography confirmed the DLC was positioned within the dilated left gonadal vein.

Findings:

  • The DLC in the left gonadal vein was functional for hemodialysis.
  • Portal hypertension in cirrhotic patients can cause collateral vessel formation and gonadal vein dilation.
  • This anatomical variation, while benign, can mimic serious complications on imaging.

Implications:

  • Accurate interpretation of imaging is vital to avoid misdiagnosis of vascular injury.
  • Understanding anatomical variations in cirrhotic patients is important for safe vascular access procedures.
  • This case highlights the need for careful radiological assessment in patients with portal hypertension.

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