title: [A Case of Delayed Vascular Injury as a Complication Related to Implanted Central Venous Port Catheter].
abstract: A 74-year-old woman with advanced gastric cancer was admitted to our hospital. A central venous (CV) port catheter was implanted into the right subclavian vein for preoperative chemotherapy and parenteral nutritional management. On the 35th day after implantation, she complained of diarrhea, fever and dyspnea. The chest radiograph showed a right-sided massive pleural effusion. As the patient progressively fell into severe respiratory distress, endotracheal intubation was performed for management of respiration by mechanical ventilation. Initially, given the patient's symptoms, she was diagnosed with septic shock. Therefore, after placement of a CV catheter through the right femoral vein, in consideration of the possibility of a port infection, she was treated with thoracentesis and infusion of antibiotics. The patient gradually recovered, and again received parenteral nutrition through the CV port catheter. After the infusion was administered, she complained of dyspnea. A CT scan of the chest revealed a right pleural effusion and displacement of the tip of the CV port catheter out of the wall of the superior vena cava. We diagnosed delayed vascular injury (DVI), and the CV port catheter was removed. She soon recovered with conservative treatment. We speculated that the initial respiratory symptoms such as the pleural effusion were caused by DVI. DVI should therefore be recognized as a complication related to implanted CV port catheters.
authors.affiliation: Dept. of Gastroenterology, Tonan Hospital.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sumiyoshi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kondo
authors.forename: Ryoji
authors.initials: R
authors.lastname: Fujii
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Minagawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujie
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kimura
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ihara
authors.forename: Naohito
authors.initials: N
authors.lastname: Yoshizaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kondo
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kitayama
authors.forename: Junko
authors.initials: J
authors.lastname: Sugiyama
authors.forename: Michiaki
authors.initials: M
authors.lastname: Hirayama
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tsuji
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Yamamoto
authors.forename: You
authors.initials: Y
authors.lastname: Kawarada
authors.forename: Shunichi
authors.initials: S
authors.lastname: Okushiba
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishioka
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D016863:Bacillaceae Infections / Q000382:microbiology*; D001409:Bacillus cereus; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D006801:Humans; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000601:surgery; D057772:Vascular System Injuries / Q000382:microbiology*