Black hole on film following catheter insertion.
Vascular accesses both permanent and temporary play an essential role in the procedure of hemodialysis (HD). The double lumen catheter (DLC) is one form of temporal vascular access which may produce different complications based on where the DLC is inserted. Here, we report a case of a cirrhotic patient receiving HD. The DLC was inserted through the left femoral vein. Later on, an unusual catheter position, mimicking a perforation in the iliac vessel, was noted in the incidental image finding. After venography, we concluded that this DLC had entered the dilated left gonadal vein, and was working well. This condition may be explained by portal hypertension leading to increased frequency of collateral branches and easy dilatation of the left gonadal vein. This condition may develop in a cirrhotic patient with portal hypertension, but there is no harm to a patient. However, this condition leads to an interesting computed tomography image, which may result in misinterpretation of the imaging reports and a clinical misdiagnosis.
Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, China.
Hsuan-Wei
HW
Chen
Jin-Shuen
JS
Chen
D000328:Adult; D002405:Catheterization, Central Venous / Q000379:methods*; D002408:Catheters, Indwelling; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D006435:Renal Dialysis / Q000379:methods*; D014057:Tomography, X-Ray Computed