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Related Concept Videos

Abdominal Aorta01:25

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Reporting and recording are crucial in data documentation. The timely, thorough, and accurate documentation of facts is essential when recording patient data. Failure to record findings during an assessment or interpretation of a problem will result in loss of information and make the patient document unreliable. The reader is left with general impressions if the information is not specific. A recording is documenting data of the individual's health information in a traceable, secure, and...
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Abdominal drain straying into right atrium: a case report.

Junya Toyoda1,2, Hitoshi Sekido3, Kazuhisa Takeda3

  • 1Department of Surgery, National Hospital Organization Yokohama Medical Center, 3-2-60, Harajuku, Totuka-Ku, Yokohama, Kanagawa, 245-8575, Japan. toynuj@gmail.com.

Surgical Case Reports
|August 8, 2019
PubMed
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Drain exchange complications can be serious. Careful guidewire use during drain exchanges is crucial to prevent accidental placement into blood vessels, avoiding severe patient outcomes.

Keywords:
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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Interventional Radiology

Background:

  • Drain exchange procedures, particularly with guidewire assistance, carry inherent risks of serious complications.
  • Accurate drain placement is critical in managing postoperative complications like bile leakage.

Purpose of the Study:

  • To report a rare case of drain misplacement into the right atrium during a complicated drain exchange.
  • To highlight the potential for severe vascular complications following abdominal drain manipulation.

Main Methods:

  • A case presentation of an 86-year-old male with complex cholangiocarcinoma undergoing hepatectomy and bile duct reconstruction.
  • Multiple drain exchanges were performed due to persistent bile leakage.
  • Imaging (CT, echocardiography) and surgical interventions were used to diagnose and manage complications.

Main Results:

  • The abdominal drain migrated into the right atrium, necessitating removal from the inferior vena cava.
  • A subsequent thrombus formation from the inferior vena cava to the right atrium was identified.
  • Surgical intervention for thrombus removal and vessel repair led to patient recovery.

Conclusions:

  • Guidewire manipulation during drain exchange requires meticulous attention to avoid intravascular placement.
  • Vigilance in monitoring drain position and potential complications is essential in postoperative care.
  • Preventing drain misplacement can avert life-threatening vascular events.