Nadir bir port kateter komplikasyonu: Ayrılma ve fistülizasyon

Onköiojik hastalarda uzun süreli kemoterapi, total parenteral beslenme ve sıvı replasmam amacıyla kullanılan ve total olarak yerleştirilebilen venih kateterler, yaşam kalitesini artırırlar. Bununla birlikte, çok faydalı olmalarına ragmen bu kateterlerin yerleştirilmesinde ve idamesinde tromboz. enfeksiyon, perforasyon. kopma, yer değiştirme ve fistidizasyon gibi (iddi komplikasyonlar meydana gelebilir. Biz bu yazımızda port kateterini bugüne kadar 6 aydır sorunsuz olarak kullanan 79 yaşında kadın hastada ortaya çıkan nadir ve şaşırtıcı bir komplikasyon olan ayrılma, kardiyak yer değiştirme ve fisiiilizasyonu sunmayı amaçladık. Kaleler haltının aspira.syonunda zorluk olması ve enjeksiyon sonrasında ağrı meydana gelmesi nedeniyle kateter yeri ile ilgili ilk kuşkular oluştu ve tanı göğüs grafisiyle konuldu. Kateter skopi altında herhangi bir komplikasyon meydana gelmeden çıkartıldı. Total olarak yerleştirilebilen venöz kateteri olan hastalar enjeksiyon sırasında kateter rezenuarı ile uyumlu göğüs duvarı bölgesinde ağrıdan yakındığında ve aspirasyon ya da enjeksiyonda zorluk olduğunda olası kateter kopmaları veya ayrılmalarına karşı araştırılmalıdırlar.

An extraordinary catheter complication: Separation and fistulization

The use of totally implantable venous devices (TIVDs) which are used for long-term chemotherapy, total parental nutrition and fluid replacement enhance the quality of life for oncological patients. However, in spite of the perfect usefulness of these devices, serious complications including thrombosis, infection, perforation, fracture, migration and fistulization may occur in the maintenance or initial intertion. We aimed at presenting a rare and suprising complication of a catheter including seperation, cardiac migration and fistulization in a 79-year-old woman who had been using the port as trouble-free for 6 months. Since there was difficulty in line aspiration and there was pain after the injection, there was suspicion about the place of the catheter and the patient was diagnosed by chest cardiograph. Catheter was removed succesfully under fluoroscopy without any incident. The patients with totally implantable venous devices must be investigated carefully for possible catheter fracture or seperation when the patient complains about pain with injection over the chest wall compatible with the localization of catheters reservoir, and difficulty during aspiration or injection.

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