title: Expect the unexpected: malposition of a large-bore central venous catheter in the urinary bladder.
abstract: We report the case of a femoral vein cannulation in a critically ill trauma patient with the malposition of a large-bore central venous catheter in the urinary bladder. Recognition of the malposition was hampered by bloody tamponade of the bladder in the context of blunt thoraco-abdominal trauma with kidney and liver laceration. A high index of clinical suspicion and the institution of adequate therapy were the key to achieving a successful clinical outcome. We discuss the anatomy of femoral veins, including their close relation to a distended bladder. The application of ultrasound even in emergency situations is stressed.
authors.affiliation: Clinic for Anaesthesia and Intensive Care Medicine, Friedrich Schiller University of Jena, Jena, Germany. cwsm.schummer@gmx.de
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schummer
authors.forename: Claudia
authors.initials: C
authors.lastname: Schummer
authors.forename: Andrej
authors.initials: A
authors.lastname: Gorse
authors.forename: Udo
authors.initials: U
authors.lastname: Becker
authors.forename: Christiane
authors.initials: C
authors.lastname: Marx
authors.forename: Martin
authors.initials: M
authors.lastname: Brauer
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D002405:Catheterization, Central Venous; D004630:Emergencies; D004632:Emergency Medical Services; D005268:Femoral Vein / Q000473:pathology; D006801:Humans; D008297:Male; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000473:pathology