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Reminder of important clinical lesson
CASE REPORT
Azygos vein cannulation after catheterisation of the left internal jugular vein in a toddler
  1. Georgios Kampouroglou1,
  2. Georgios Noutsos2,
  3. Panagiotis Skandalakis3 and
  4. Petros Mirilas4
  1. 1 Department of Pediatric Surgery, Geniko Nosokomeio Paidon Agia Sofia, Athens, Greece
  2. 2 Department of Anesthesiology, Geniko Nosokomeio Paidon Agia Sofia, Athens, Greece
  3. 3 Department of Anatomy, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  4. 4 Department of Surgery, Emory University, Atlanta, Georgia, USA
  1. Correspondence to Dr Georgios Kampouroglou, gkampouroglou{at}gmail.com

Abstract

Central venous catheterisation is routinely performed in paediatric patients to facilitate therapeutic management when long-term vascular access is needed. Misplacement of the catheter tip in thoracic vessels other than the superior vena cava has been described, along with related complications. Hereby, a case of a 15-month-old child is presented with a fully functional Hickman catheter introduced via the left internal jugular vein. The tip of the catheter was misplaced into the azygos vein. Intraoperative spot fluoroscopic images and anatomical explanations for the course of the catheter are presented. An understanding of the aetiology of the radiological appearance may help to increase recognition of such cases and avoid complications.

  • paediatric surgery
  • vascular surgery

http://dx.doi.org/10.1136/bcr-2018-227930

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    Footnotes

    • Contributors GK: designed, gathered data and wrote the case report, and gave final approval of the version to be published. GN: helped with planning and writing of the case report, and gave final approval of the version to be published. PS: encouraged the idea, provided feedback, and gave final approval of the version to be published. PM: helped with planning and writing of the case report, provided important feedback, supervised all activities related to the case,and gave final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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