Bir Hemşirenin Kâbusu: Bir Yabancı Cisim Olarak Kol Veninde Bir İntavenöz Kateterin Yarısı

Abstract

A nightmare of a nurse, half of an intravenous catheter as a foreign body in arm vein

Abstract

A 33-year-old male patient presented with a venous catheter left inside his left arm after an attempt to remove the catheter by a nurse. This arm vein was catheterized for a computerized tomography screening. No active bleeding was observed and a tubular foreign body was palpable on the anterior surface of the cubital fossa. Ultrasonographic examination of the arm revealed half of a catheter in the antecubital vein. Laboratory tests showed no abnormalities including the cardiac panel. Peripheral arterial pulses were palpable. The chest CT scan and echocardiogram were within normal limits. Following preoperative preparation, the patient was undertaken to surgery under local anaesthesia. Surgical skin incision was made over and along the vein. The foreign body was totally excised after venotomy. Early postoperative clinical follow up was uneventful and the patient discharged without complication. Foreign bodies in the venous system have a risk of migrating. A cardiac and/or pulmonary embolization may result in severe morbidity or mortality1,2. Thus, the detection of a foreign body in any vein requires immediate excision. Excisions may include percutaneous interventions3 and direct surgical approaches. The latter technique may not always be practical. A delay in surgery may result in a rapid foreign body migration to the right chambers of the heart and lungs. Such migration may complicate these cases and an open-heart surgery may be the next necessary step to solve the issue. A physical examination, medical history, and ultrasonographic evidence of foreign body are essential for early diagnosis and intervention.

Keywords

• : Intravenous foreign body, surgical removal

References

1. Referans 1. Koirala B, Shrestha KR, Thapa B et al. Migration of a piece of shrapnel: femoral vein to superior vena cava-azygous junction, Eur J Cardiothorac Surg ,2012;42:584-6
2. Referans 2. Wang X, Zhao X, Du D, Xiang X. Management of metallic foreign bodies in the heart, J Card Surg 2012;27:704-6
3. Referans3. R.F. Bonvini, A. Rastan, S. Sixt, et al.Percutaneous retrieval of intravascular and intracardiac foreign bodies with a dedicated three-dimensional snare: a 3-year single center experience. Catheter Cardiovasc Interv, 2009;74:939-45