RESUMO
A 64-year-old female was admitted due to iliopsoas abscess caused by misplacement of a central venous catheter (CVC) into the ascending lumbar vein (ALV). Despite removing the CVC and administering an antimicrobial agent, her general condition did not improve. Therefore, we performed a contrast-enhanced head computed tomography (CT) scan. The CT scan revealed a cerebellum abscess. Surgical cerebellum abscess drainage was thus performed urgently. We recommend using anteroposterior radiographs, J-guide wire catheter and ultrasound guidance to prevent misplacement. If misplacement of the CVC is suspected, it should be removed and a CT scan performed without hesitation as soon as possible.
RESUMO
<b>Introduction</b> : Catheter which strays in the ascending lumbar vein during femoral vein catheterization can cause complications such as retroperitoneal hematoma. However, not much is known of this phenomenon.<br><b>Methods</b> : We retrospectively studied 107 patients who had indwelling femoral vein catheter in our hospital between March 2013 and April 2011.<br><b>Results</b> : The catheter went straying in the ascending lumbar vein 11/110 times (10.0%) , 5/34 times (14.7%) on the left side, and 6/76 times (7.9%) on the right side. The possibility of the catheter straying was maximum when the catheter was displaced laterally or raised sharply towards the caudal side, as seen through abdominal radiographic examination.<br><b>Conclusion</b> : Femoral central venous catheter misplacement in the ascending lumbar veins is fairly common. Tests such as additional abdominal CT or radiographs should be conducted if misplacement is suspected.