Expect the unexpected: malposition of a large-bore central venous catheter in the urinary bladder.
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.
Schummer
Wolfram
W
Clinic for Anaesthesia and Intensive Care Medicine, Friedrich Schiller University of Jena, Jena, Germany. cwsm.schummer@gmx.de
Schummer
Claudia
C
Gorse
Andrej
A
Becker
Udo
U
Marx
Christiane
C
Brauer
Martin
M
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