Azygos vein cannulation after catheterisation of the left internal jugular vein in a toddler

• Type of Material: Article
• Authors: Georgios Kampouroglou, Geniko Nosokomeio Paidon Agia Sofia; Georgios Noutsos, Geniko Nosokomeio Paidon Agia Sofia; Panagiotis Skandalakis, University of Athens; Petros Mirilas, Emory University
• Language: English
• Date: 2019-01-17
• Publisher: BMJ Publishing Group
• Publication Version: Final Published Version
• Copyright Statement: © 2019 BMJ Publishing Group Ltd. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bcr-2018-227930
• Title of Journal or Parent Work: BMJ Case Reports
• Volume: 12
• Issue: 1
• Grant/Funding Information: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
• Keywords: vascular surgery; Anatomy & Morphology; Anesthesiology; paediatric surgery
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery; Biology, Anatomy

Abstract

Central venous catheterisation is routinely performed in paediatric patients to facilitate therapeutic management when long-term vascular access is needed. Misplacement of the catheter tip in thoracic vessels other than the superior vena cava has been described, along with related complications. Hereby, a case of a 15-month-old child is presented with a fully functional Hickman catheter introduced via the left internal jugular vein. The tip of the catheter was misplaced into the azygos vein. Intraoperative spot fluoroscopic images and anatomical explanations for the course of the catheter are presented. An understanding of the aetiology of the radiological appearance may help to increase recognition of such cases and avoid complications.