title: Budd-Chiari syndrome secondary to catheter-associated inferior vena cava thrombosis.
abstract: BACKGROUND
  Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD.
  
  
  METHODS
  A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days. She had a tunneled dialysis catheter placed at the left jugular vein. The diagnosis of BCS was established by abdominal computed tomography that showed a partial thrombus within the inferior vena cava which extended from the right atrium to medium hepatic vein, and continuing along the left hepatic vein. Patient was treated with anticoagulants and discharged asymptomatic.
  
  
  CONCLUSIONS
  Budd-Chiari syndrome is a rare medical condition caused by hepatic veins thrombosis. It can involve one, two, or all three of the major hepatic veins. It is usually related to myeloproliferative disorders, malignancy and hypercoagulable states. This case calls attention for inadvertent catheter tip placement into hepatic vein leading to this rare complication.
  
  
  CONCLUSIONS
  Assessment of catheter dialysis tip location with radiological image seems to be a prudent measure after each procedure even if the tunneled dialysis catheter has been introduced with fluoroscopy image.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Gustavo N
authors.initials: GN
authors.lastname: Araujo
authors.affiliation: Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Luciane M
authors.initials: LM
authors.lastname: Restelatto
authors.affiliation: Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Prompt
authors.affiliation: Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Cristina
authors.initials: C
authors.lastname: Karohl
mesh_terms: D000328:Adult; D006502:Budd-Chiari Syndrome / Q000209:etiology*; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D006801:Humans; D013927:Thrombosis / Q000150:complications* / Q000209:etiology*; D014682:Vena Cava, Inferior