Related Experiment Videos
Budd-Chiari syndrome secondary to catheter-associated inferior vena cava thrombosis
Gustavo N Araujo1, Luciane M Restelatto1, Carlos A Prompt1
1Hospital de Clínicas de Porto Alegre, Brazil.
Insights
This case report highlights a rare complication of central venous catheter misplacement in a patient with chronic kidney disease (CKD), leading to Budd-Chiari syndrome (BCS). Prompt diagnosis and anticoagulant treatment resulted in a favorable outcome.
Area of Science:
- Nephrology
- Vascular Surgery
- Radiology
Background:
- Patients with chronic kidney disease (CKD) face elevated risks of thrombotic events.
- Central venous catheters used for dialysis access further exacerbate this thrombotic risk.
- This report details the first documented instance of Budd-Chiari syndrome (BCS) resulting from central venous catheter misplacement in a CKD patient.
Introduction:
Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD.
Case Report:
A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days. She had a tunneled dialysis catheter placed at the left jugular vein. The diagnosis of BCS was established by abdominal computed tomography that showed a partial thrombus within the inferior vena cava which extended from the right atrium to medium hepatic vein, and continuing along the left hepatic vein. Patient was treated with anticoagulants and discharged asymptomatic.
Discussion:
Budd-Chiari syndrome is a rare medical condition caused by hepatic veins thrombosis. It can involve one, two, or all three of the major hepatic veins. It is usually related to myeloproliferative disorders, malignancy and hypercoagulable states. This case calls attention for inadvertent catheter tip placement into hepatic vein leading to this rare complication.
Conclusion:
Assessment of catheter dialysis tip location with radiological image seems to be a prudent measure after each procedure even if the tunneled dialysis catheter has been introduced with fluoroscopy image.