Arch of Aorta Cannulation through Right Internal Jugular Vein Causing Brachial Artery Embolism: A Rare Case
Year: 2024
Type: article
Study design: Case Report
Abstract: remained tachycardic and soon developed shortness of breath, hypoxia, and shock (BP: 80/40 mm Hg, pulse: 130 bpm, oxygen saturation: 80%).In view of deterioration of clinical condition, she was intubated and started on mechanical ventilation and inotropic support.Under guidance of real-time ultrasound, a right IJV central venous catheter (CVC) was established.There was smooth dark blood aspirated by the introducer needle through which guidewire was placed without obstruction and catheter railroaded post ultrasound confirmation of guidewire in the IJV.The catheter was fixed at 12 cm.Left radial arterial access was subsequently established.2D-echocardiography revealed global hypokinesia with a left ventricular ejection fraction of IntroductIonCentral venous catheterization is routinely performed for a variety of clinical indications in critically ill patients.The internal jugular vein (IJV) is the preferred vein because of its direct route to the heart and minimal risk of stenosis and thrombosis. 1 Complications associated with central venous catheterization include infection, catheter failure, arterial puncture, catheter malposition, pneumothorax, hematoma, hemothorax, asystolic cardiac arrest of unknown etiology, inferior vena cava (IVC) trauma, pneumothorax, chylothorax, catheter embolism, brachial plexus injury, venous or cardiac perforation, air embolism, and ventricular guidewire entrapment.2,3 case descrIptIon A 60-year-old hypertensive and diabetic female presented to the emergency department (ED) with accidental ingestion of her denture 4 hours prior to arrival.On arrival, her blood pressure (BP) was 170/100 mm Hg, heart rate was 140 beats per minute, respiratory rate was 30 breaths per minute, oxygen saturation was 99% on room air, and random blood glucose was 355 mg/dL.X-ray of the chest done prior to presenting to the department showed the presence of a foreign body with a sharp edge in the esophagus.In consultation with the gastroenterology team, a noncontrast computed tomography (NCCT) of neck and chest was performed, which confirmed a 2.5 cm foreign body in the upper esophagus.The patient was given analgesia, insulin infusion, and prepped for urgent endoscopic removal under sedation.After removal of the denture in the ED, the patient 1-
Authors: Ankur Verma, Amit Vishen, Meghna Haldar, Sanjay Jaiswal, Rinkey Ahuja, Wasil R Sheikh, Abbas A Khatai, Kushagra Gupta
Institution: Max Super Speciality Hospital
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4405886196