title: [Perforation of the internal jugular vein during cannulation for haemodialysis].
abstract: BACKGROUND
  Reliable temporary vascular access is necessary for haemodialysis when the establishment of permanent access is not possible. Double-lumen catheters are favoured in most cases. These catheters are commonly inserted percutaneously using anatomic landmarks, but the technique is far from being perfect and serious complications may occur during the procedure. We describe a serious and potentially lethal complication of internal jugular venous cannulation.
  
  
  METHODS
  A 50-year-old woman was transferred from another hospital because of misplacement of a tunnelled permanent haemodialysis catheter and internal bleeding. A computed tomographic angiogram of the chest revealed that the catheter had migrated to the mediastinum. Emergency surgery with cardiopulmonary bypass was performed, the catheter removed, and the damaged left internal jugular and right subclavian veins were reconstructed.
  
  
  CONCLUSIONS
  Migration of a dialysis catheter outside the vascular bed is a potentially lethal complication. Removal of a misplaced catheter may lead to massive uncontrolled bleeding and should be managed surgically.
authors.affiliation: II Klinika Anestezjologii i Intensywnej Terapii Warszawskiego UM.
authors.forename: Jacek
authors.initials: J
authors.lastname: Wadełek
authors.forename: Dominik
authors.initials: D
authors.lastname: Drobiński
authors.forename: Piotr
authors.initials: P
authors.lastname: Szewczyk
authors.forename: Fouad
authors.initials: F
authors.lastname: Abbas
authors.forename: Marzena
authors.initials: M
authors.lastname: Franczyk
authors.forename: Monika
authors.initials: M
authors.lastname: Niewińska
authors.forename: Franciszek
authors.initials: F
authors.lastname: Majstrak
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Gałazka
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kański
mesh_terms: D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007601:Jugular Veins / Q000293:injuries*; D008482:Mediastinum; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery