title: Ruptured superior thyroid artery from central vein cannulation: treatment by coil embolization.
abstract: Central vein cannulation is associated with several complications, some of which may be fatal. This case report describes a life-threatening complication after insertion of a central venous line. An obese female patient with end-stage renal failure due to nephrotic syndrome developed a huge neck swelling and sudden airway obstruction after attempted cannulation of the internal jugular vein for haemodialysis. Tracheal intubation was achieved using a gum-elastic bougie. Investigations revealed abnormal blood clotting. The coagulopathy was treated, but the neck swelling continued to increase in size. Carotid angiography showed a ruptured right superior thyroid artery. The haemorrhage was controlled by coil embolization of the artery. This case report demonstrates the usefulness of the gum-elastic bougie in the presence of a difficult airway and of interventional radiology in the management of vascular accidents.
authors.affiliation: Department of Cardiothoracic Anaesthesia, Freeman Hospital, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK.
authors.forename: V
authors.initials: V
authors.lastname: Jeganath
authors.forename: J G
authors.initials: JG
authors.lastname: McElwaine
authors.forename: P
authors.initials: P
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000792:Angiography; D001158:Arteries / Q000293:injuries; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D012421:Rupture / Q000000981:diagnostic imaging / Q000209:etiology; D013961:Thyroid Gland / Q000098:blood supply*