Ultrasound-guided central venous puncture in an obese patient with cervical adenomegaly.
OBJECTIVE
Classical central venous techniques are based on superficial anatomical references and the knowledge of the vascular anatomy of the area to be punctured. The ultrasound allows direct vision of vascular and perivascular structures, and the needle during the procedure. The objective of this report was to describe an ultrasound-guided central venous catheter placement in an obese patient with adenomegaly.


METHODS
This is a 28 years old white male patient, with 1.70 m, weighing 120 kg, with the diagnosis of nodular sclerosis Hodgkin's lymphoma. An ultrasound-guided internal jugular vein catheter placement was requested to the Anesthesiology Department of the Hospital Governador Celso Ramos due to the presence of a supraclavicular node that would hinder the anatomical reference for the puncture in an obese patient. After obtaining the best image, the left internal jugular vein was punctured and a triple lumen catheter was introduced. It was necessary only a single puncture and the catheter was easily introduced; no complications developed during the procedure.
CET/SBA Integrado de Anestesiologia da Secretaria de Estado de Saúde de Santa Catarina do Hospital Governador Celso Ramos, Florianópolis, SC.
Jaderson
J
Wollmeister
Diogo Bruggemann
DB
da Conceição
Pablo Escovedo
PE
Helayel
Ricardo Kotlinsky
RK
dos Santos
D000328:Adult; D002405:Catheterization, Central Venous / Q000379:methods*; D006801:Humans; D008206:Lymphatic Diseases / Q000150:complications*; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging*; D009765:Obesity / Q000150:complications*; D014463:Ultrasonography