title: A new site for venous access: superficial veins of portal collateral circulation.
abstract: In case of failure of peripheral vascular access, classical alternatives are central venous or intraosseous access. We report a new site of vascular access necessitating no specific material. A 53-year-old patient with cirrhosis-induced coagulopathy, portal hypertension, and collateral abdominal portosystemic circulation required parenteral antibiotherapy. After failure of peripheral vein catheterization, he was addressed to our resuscitation room for central venous access. To avoid the risks associated with this invasive procedure, we chose an alternative approach. After skin preparation, a 20-gauge peripheral venous catheter was inserted in a dilated subcutaneous vein of abdominal wall. To our knowledge, it is the first human report of insertion of a catheter in a superficial vein of abdominal wall. It could be an alternative approach for vascular access after failure of peripheral venipuncture in patients with portal hypertension.
authors.affiliation: Department of Anesthesiology, Desgenettes Military Hospital Lyon, France. jeanturc@free.fr
authors.forename: Jean
authors.initials: J
authors.lastname: Turc
authors.forename: Laurent
authors.initials: L
authors.lastname: Gergelé
authors.forename: Rachid
authors.initials: R
authors.lastname: Attof
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mottard
authors.forename: Michel
authors.initials: M
authors.lastname: Bérend
authors.forename: Jean-Stéphane
authors.initials: JS
authors.lastname: David
mesh_terms: D034861:Abdominal Wall / Q000098:blood supply*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002406:Catheterization, Peripheral / Q000379:methods*; D003097:Collateral Circulation; D006801:Humans; D007262:Infusions, Intravenous; D008103:Liver Cirrhosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011168:Portal System; D014680:Veins
chemical_list: D000900:Anti-Bacterial Agents