Boyundaki Fırtına Kontrol Altında, Batında Kriz Başladı: Olgu sunumu
Yıl 2026,
Cilt: 5 Sayı: 1
,
10
-
14
,
01.05.2026
Hacı Mehmet Çitil
,
Furkan Dokumacı
,
Lezan Keskin
,
Burhan Hakan Kanat
,
Azize Yetişgen
,
Battal Selçuk Çakmak
,
Ömer Nasuhi Aydın
Öz
Terapötik plazma değişimi (TPE), antitiroid tedaviye dirençli olgularda veya cerrahi öncesi dönemde hızlı hormonal kontrol sağlanması gereken hipertiroidi hastalarında kullanılan etkili bir köprü tedavisidir. Bununla birlikte, TPE uygulaması için sıklıkla gerekli olan santral venöz kateterizasyon (SVK), nadir görülmekle birlikte potansiyel olarak ciddi komplikasyonlara yol açabilen invaziv bir girişimdir. Olgumuz 42 yaşında bir kadın hastadır. Tiroidektomi öncesinde hızlı ve etkin hormonal kontrol sağlamak amacıyla TPE planlandı. TPE için uygulanan venöz kateterizasyonu takiben retroperitoneal hematom gelişmiş ve buna eş zamanlı derin ven trombozu (DVT) eşlik etmiştir. Bu çalışmada, venöz kateterizasyona bağlı gelişen bu nadir komplikasyonun klinik seyri, takibi ve tedavi yönetimi sunulmaktadır.
Kaynakça
-
1. Lee SY, Pearce EN. Hyperthyroidism: A Review. JAMA. 2023 Oct
17;330(15):1472-1483. doi: 10.1001/jama.2023.19052. PMID: 37847271; PMCID: PMC10873132.
-
2. Yu X, Tang J, Wang L, Sun Z, Ma J, Zhou T, Liu X, Li Y, Zhang B. The diagnosis and treatment of hyperthyroidism: a bibliometric analysis from 2004 to
2024. Gland Surg. 2025 Jun 30;14(6):1140-1153. doi: 10.21037/gs-2025-228.
Epub 2025 Jun 26. PMID: 40671780; PMCID: PMC12261356.
-
3.Giordani I, Sykiotis GP. A short review of current knowledge regarding longterm treatment of Graves' disease with antithyroid drugs. Hormones (Athens).
2025 Jun;24(2):347-358. doi: 10.1007/s42000-024-00618-y. Epub 2024 Dec 5.
PMID: 39636385; PMCID: PMC12339586.
-
4. Uludag M, Cetinoglu I, Taner Unlu M, Caliskan O, Aygun N. Preoperative Preparation in Hyperthyroidism and Surgery in the Hyperthyroid State. Sisli Etfal
Hastan Tip Bul. 2024 Sep 30;58(3):263-275. doi: 10.14744/SEMB.2024.97253.
PMID: 39411040; PMCID: PMC11472198.
-
5. Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, Patriquin CJ, Pham HP, Sanchez AP, Schneiderman J, Witt V, Zantek ND, Dunbar NM. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the
American Society for Apheresis: The Ninth Special Issue. J Clin Apher. 2023
Apr;38(2):77-278. doi: 10.1002/jca.22043. PMID:37017433.
https://www.ammtac.org/docs/articulos/Guias%20ASFA%202023_compressed.pdf
-
6. Tizianel I, Sabbadin C, Censi S, Clausi C, Colpo A, Leahu AI, Iacobone M,
Mian C, Scaroni C, Ceccato F. Therapeutic Plasma Exchange for the Treatment
of Hyperthyroidism: Approach to the Patient with Thyrotoxicosis or Antithyroid-Drugs Induced Agranulocytosis. J Pers Med. 2023 Mar 13;13(3):517. doi:
10.3390/jpm13030517. PMID: 36983698; PMCID: PMC10056870.
-
7. Shah Z, Khan I, Dixe de Oliveira Santo I. Intraperitoneal Hematoma After
Femoral Catheterization: A Case Report and Literature Review. Cureus. 2022
May 19;14(5):e25140. doi: 10.7759/cureus.25140. PMID: 35733506; PMCID:
PMC9205448.
-
8. Kornbau C, Lee KC, Hughes GD, Firstenberg MS. Central line complications.
Int J Crit Illn Inj Sci. 2015 Jul-Sep;5(3):170-8. doi: 10.4103/2229-5151.164940.
PMID: 26557487; PMCID: PMC4613416.
-
9. Merrer J, De Jonghe B, Golliot F, et al. Complications of Femoral and Subclavian Venous Catheterization in Critically Ill Patients: A Randomized Controlled
Trial. JAMA. 2001;286(6):700–707. doi:10.1001/jama.286.6.700
-
10. Uramoto H, Yano K, Hachida M, Mori A, Yasumoto K. Inferior vena cava
injury after catheterization: report of a case. Hepatogastroenterology. 2001 MarApr;48(38):432-3. PMID: 11379325.
-
11. Akata T, Nakayama T, Kandabashi T, Kodama K, Takahashi S. Massive
retroperitoneal hemorrhage associated with femoral vein cannulation. J Clin
Anesth. 1998 Jun;10(4):321-6. doi: 10.1016/s0952-8180(98)00036-1. PMID:
9667349.
-
12. Castro D, Martin Lee LM, Bhutta BS. Femoral Vein Central Venous Access(Archived). 2023 Aug 17. In: StatPearls [Internet]. Treasure Island (FL):
StatPearls Publishing; 2026 Jan–. PMID: 29083581.
-
13. Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, Rigaud
JP, Casciani D, Misset B, Bosquet C, Outin H, Brun-Buisson C, Nitenberg G;
French Catheter Study Group in Intensive Care. Complications of femoral and
subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA. 2001 Aug 8;286(6):700-7. doi: 10.1001/jama.286.6.700.
PMID: 11495620.
Storm in the Neck Controlled, Crisis in the Abdomen Emerges: A Case Report
Yıl 2026,
Cilt: 5 Sayı: 1
,
10
-
14
,
01.05.2026
Hacı Mehmet Çitil
,
Furkan Dokumacı
,
Lezan Keskin
,
Burhan Hakan Kanat
,
Azize Yetişgen
,
Battal Selçuk Çakmak
,
Ömer Nasuhi Aydın
Öz
Therapeutic plasma exchange (TPE) is an effective bridging therapy used in patients with hyperthyroidism who are resistant to antithyroid medications or those requiring rapid hormonal control preoperatively. However, central venous catheterization (CVC), which is frequently required for the administration, is an invasive procedure that may rarely lead to potentially serious complications. Our case is a 42-year-old female patient. TPE was planned to achieve rapid and effective hormonal control prior to thyroidectomy. Following venous catheterization for TPE, a retroperitoneal hematoma developed, accompanied by concurrent deep vein thrombosis (DVT). In this study, we present the clinical course, follow-up, and management of this rare complication associated with venous catheterization.
Kaynakça
-
1. Lee SY, Pearce EN. Hyperthyroidism: A Review. JAMA. 2023 Oct
17;330(15):1472-1483. doi: 10.1001/jama.2023.19052. PMID: 37847271; PMCID: PMC10873132.
-
2. Yu X, Tang J, Wang L, Sun Z, Ma J, Zhou T, Liu X, Li Y, Zhang B. The diagnosis and treatment of hyperthyroidism: a bibliometric analysis from 2004 to
2024. Gland Surg. 2025 Jun 30;14(6):1140-1153. doi: 10.21037/gs-2025-228.
Epub 2025 Jun 26. PMID: 40671780; PMCID: PMC12261356.
-
3.Giordani I, Sykiotis GP. A short review of current knowledge regarding longterm treatment of Graves' disease with antithyroid drugs. Hormones (Athens).
2025 Jun;24(2):347-358. doi: 10.1007/s42000-024-00618-y. Epub 2024 Dec 5.
PMID: 39636385; PMCID: PMC12339586.
-
4. Uludag M, Cetinoglu I, Taner Unlu M, Caliskan O, Aygun N. Preoperative Preparation in Hyperthyroidism and Surgery in the Hyperthyroid State. Sisli Etfal
Hastan Tip Bul. 2024 Sep 30;58(3):263-275. doi: 10.14744/SEMB.2024.97253.
PMID: 39411040; PMCID: PMC11472198.
-
5. Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, Patriquin CJ, Pham HP, Sanchez AP, Schneiderman J, Witt V, Zantek ND, Dunbar NM. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the
American Society for Apheresis: The Ninth Special Issue. J Clin Apher. 2023
Apr;38(2):77-278. doi: 10.1002/jca.22043. PMID:37017433.
https://www.ammtac.org/docs/articulos/Guias%20ASFA%202023_compressed.pdf
-
6. Tizianel I, Sabbadin C, Censi S, Clausi C, Colpo A, Leahu AI, Iacobone M,
Mian C, Scaroni C, Ceccato F. Therapeutic Plasma Exchange for the Treatment
of Hyperthyroidism: Approach to the Patient with Thyrotoxicosis or Antithyroid-Drugs Induced Agranulocytosis. J Pers Med. 2023 Mar 13;13(3):517. doi:
10.3390/jpm13030517. PMID: 36983698; PMCID: PMC10056870.
-
7. Shah Z, Khan I, Dixe de Oliveira Santo I. Intraperitoneal Hematoma After
Femoral Catheterization: A Case Report and Literature Review. Cureus. 2022
May 19;14(5):e25140. doi: 10.7759/cureus.25140. PMID: 35733506; PMCID:
PMC9205448.
-
8. Kornbau C, Lee KC, Hughes GD, Firstenberg MS. Central line complications.
Int J Crit Illn Inj Sci. 2015 Jul-Sep;5(3):170-8. doi: 10.4103/2229-5151.164940.
PMID: 26557487; PMCID: PMC4613416.
-
9. Merrer J, De Jonghe B, Golliot F, et al. Complications of Femoral and Subclavian Venous Catheterization in Critically Ill Patients: A Randomized Controlled
Trial. JAMA. 2001;286(6):700–707. doi:10.1001/jama.286.6.700
-
10. Uramoto H, Yano K, Hachida M, Mori A, Yasumoto K. Inferior vena cava
injury after catheterization: report of a case. Hepatogastroenterology. 2001 MarApr;48(38):432-3. PMID: 11379325.
-
11. Akata T, Nakayama T, Kandabashi T, Kodama K, Takahashi S. Massive
retroperitoneal hemorrhage associated with femoral vein cannulation. J Clin
Anesth. 1998 Jun;10(4):321-6. doi: 10.1016/s0952-8180(98)00036-1. PMID:
9667349.
-
12. Castro D, Martin Lee LM, Bhutta BS. Femoral Vein Central Venous Access(Archived). 2023 Aug 17. In: StatPearls [Internet]. Treasure Island (FL):
StatPearls Publishing; 2026 Jan–. PMID: 29083581.
-
13. Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, Rigaud
JP, Casciani D, Misset B, Bosquet C, Outin H, Brun-Buisson C, Nitenberg G;
French Catheter Study Group in Intensive Care. Complications of femoral and
subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA. 2001 Aug 8;286(6):700-7. doi: 10.1001/jama.286.6.700.
PMID: 11495620.