Thoracic duct cannulation during left internal jugular vein cannulation:A case report  

作　　者：Geal Hong Hwang Woosik Eom 

机构地区：[1]Department of Anesthesiology and Pain Medicine,National Cancer Center,Goyang-si 10408,Gyeonggi-do,South Korea

出　　处：《World Journal of Clinical Cases》2023年第34期8200-8204,共5页世界临床病例杂志

摘　　要：BACKGROUND Central venous catheter insertion is an invasive procedure that can cause complications such as infection,embolization due to air or blood clots,pneumothorax,hemothorax,and,rarely,chylothorax due to damage to the thoracic duct.Herein,we report a case of suspected thoracic duct cannulation that occurred during left central venous catheter insertion.Fortunately,the patient was discharged without any adverse events related to thoracic duct cannulation.CASE SUMMARY A 46-year-old female patient presented at our department to undergo cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.During anesthesia,we decided to insert a central venous catheter through the left internal jugular vein because the patient already had a chemoport through the right central vein.During the procedure,blood reflux was observed when the needle tip was not within the ultrasound field of view.We did not try to find the tip;however,a guide wire and a central venous catheter were inserted without any resistance.Subsequently,when inducing blood reflux from the distal port of the central venous catheter,only clear fluid,suspected to be lymphatic fluid,was regurgitated.Further,chest X-ray revealed an appearance similar to that of the path of the thoracic duct.Given that intravenous fluid administration was not started and no abnormal fluid collection was noted on preoperative chest X-ray,we suspected thoracic duct cannulation.CONCLUSION It is important to use ultrasound to confirm the exact position of the needle tip and guide wire path.

关 键 词：Central venous catheter insertion Left internal jugular vein Thoracic duct LYMPH ULTRASOUND Case report 

分 类 号：R543[医药卫生—心血管疾病]