RESUMO
We present a case of isolated rectal ischaemia, a rare complication after emergency surgery for a ruptured abdominal aneurysm. We discuss the possible aetiology of this condition and how this rare condition may be missed unless care is taken at the time of reoperation.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/cirurgia , Implante de Prótese Vascular/normas , Procedimentos Endovasculares/normas , Medicina de Emergência Baseada em Evidências/normas , Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Fatores Etários , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/mortalidade , Ruptura Aórtica/diagnóstico , Ruptura Aórtica/mortalidade , Prótese Vascular , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Implante de Prótese Vascular/mortalidade , Comorbidade , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/mortalidade , Feminino , Humanos , Rim/fisiopatologia , Masculino , Desenho de Prótese , Medição de Risco , Fatores de Risco , Fatores Sexuais , Stents , Resultado do TratamentoRESUMO
PURPOSE: To describe the successful removal of a knotted Seldinger wire from a subclavian vein, and review the design and structure of guidewires to formulate recommendations to minimize complications associated with the Seldinger technique. CLINICAL FEATURES: An 81-yr-old patient suffered from an intravascular knotting of a Seldinger wire during subclavian venous cannulation. We describe a technique for successful removal of knotted guidewire under fluoroscopic guidance using the vessel dilator of a central venous cannulation kit. In this case, the technique was successful without associated immediate or delayed complications. Although central venous cannulation with the Seldinger technique is a commonly performed procedure, it may result in numerous complications, including kinking, and rarely complete knotting of the guidewire. CONCLUSIONS: A thorough understanding of procedural complications and physical characteristics of the guidewire is vital in order to ensure patient safety when using the Seldinger technique for central venous cannulation. We have reviewed the relevant literature for guidewire design and structure, associated complications, and provide recommendations for safe use of guidewires.
