[Differential diagnosis of postoperative fistulas of the urinary tract (author's transl)]
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Der Urologe. Ausg. A
|January 1, 1979
Insights
An intravenous catheter misplaced into the inferior vena cava caused a retroperitoneal tumor. Tumor puncture led to a fistula, initially misdiagnosed as a urinary tract issue.
Area of Science:
- Vascular surgery
- Interventional radiology
- Surgical oncology
Background:
- Central venous catheterization is a common procedure.
- Complications can arise from improper placement.
- Accurate diagnosis is crucial for patient outcomes.
Observation:
- An indwelling intravenous catheter was mistakenly advanced through the subclavian vein and right heart into the inferior vena cava.
- The catheter perforated the inferior vena cava wall, leading to extravasation of infusate.
- Continued infusion resulted in the formation of a cystic retroperitoneal tumor.
Findings:
- The retroperitoneal tumor was successfully punctured.
- A fistula formed subsequent to the tumor puncture.
- This fistula was initially misidentified as a urinary tract fistula.
Implications:
- Highlights the importance of meticulous technique during central venous catheterization.
- Underscores the potential for rare complications leading to diagnostic challenges.
- Emphasizes the need for comprehensive differential diagnosis in complex cases.
Abstract:
A case is demonstrated in which an indwelling intravenous catheter was pushed by mistake via V. subclavia and the right heart into the V. cava inf. There the catheter perforated the wall of the V. cava. The continued infusion induced a cystic retroperitoneal tumor. The puncture of this tumor was followed by a fistula that was misinterpreted as a fistula of the urinary tract.