ABSTRACT
Totally implantable central venous access devices, or ports, are commonly used for those patients which require long-term or continuum intravenous infusion therapy. We report a case of a rare complication related to them, called pinch-off syndrome, arising by the chronic compression of the central venous catheter between the clavicle and the first rib, with consequent mechanic obstruction of the catheter and eventual complete transection and embolization of a distal fragment of it. A chest radiograph, eventually with the injection of contrast through the catheter, is require when pain and/or swelling in the chest or shoulder at the side go the port occur at the time of infusion plus malfunction of it. The therapy of pinch-off syndrome is removal of the fractured or with embolism catheter and replacement of a new one more laterally to the previous approach.
Subject(s)
Catheterization, Central Venous/adverse effects , Device Removal , Embolism/etiology , Subclavian Vein , Adenocarcinoma/drug therapy , Adenocarcinoma/pathology , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Catheterization, Central Venous/instrumentation , Catheters, Indwelling/adverse effects , Clavicle/diagnostic imaging , Embolism/diagnostic imaging , Embolism/prevention & control , Equipment Failure , Female , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Middle Aged , Radiography , Ribs/diagnostic imaging , Subclavian Vein/diagnostic imaging , SyndromeABSTRACT
The Authors report on a rare case of blunt traumatic injury of the gallbladder. A careful clinical examination, an abdominal ultrasonography and a contrast material-enhanced computed tomography have a primary importance for a correct diagnosis. Laparoscopic surgery has an important diagnostic and, in selected cases, therapeutic role. In all traumatic gallbladder ruptures, after an accurate search of eventual associated injuries of other abdominal organs, cholecystectomy is considered the treatment of choice.
