title: Case report of a difficult venous access: retroperitoneal approach of inserting an improved non-heparinised port for long-term use.
abstract: This is a case report of a patient with difficult venous access following thrombosis of major superficial and deep veins of the limbs as documented by ultrasound doppler and venography. The insertion of a few central ports were infected and the vein thrombosed. Venography revealed that central venous access was no longer feasible. The previous laparotomies had resulted in dense intra-peritoneal adhesions, and rendered further laparotomy virtually impossible. The patient had occasional adhesion colics, vomiting and hypoglycemic episodes. A rarely performed retro-peritoneal approach of inserting an improved non-heparinised port proved to be effective for long-term management of this patient. The surgical approach and the selected port are discussed.
authors.affiliation: Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur.
authors.forename: K Y
authors.initials: KY
authors.lastname: Chan
authors.forename: C M
authors.initials: CM
authors.lastname: Teoh
authors.forename: N
authors.initials: N
authors.lastname: Sukumar
mesh_terms: D000328:Adult; D002405:Catheterization, Central Venous / Q000379:methods*; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D012187:Retroperitoneal Space / Q000098:blood supply; D014682:Vena Cava, Inferior