中心静脈カテーテルの内頸静脈内長期留置による内頸静脈血栓症・深頸部膿瘍例

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A 66-year-old female patient with spinocerebellar degeneration and long-term incorrect placement of a central venous catheter was referred to our hospital with persistent fever and right neck swelling. Preoperative computed tomography (CT) showed the misplacement of catheter, which was inserted through the right subclavian vein but had turned upward into the upper internal jugular vein causing intravascular thrombosis. A deep neck abscess was also found around the catheter tip. The patient was diagnosed as having central venous catheter-related infection. As the catheter could not be extracted, we performed neck dissection under general anesthesia. The internal jugular vein was identified in the middle of the abscess cavity. Inside the venous lumen filled with the abscess fluid and thrombosis, we found the catheter tip. The catheter was carefully removed without bleeding. Postoperative treatment was effective, and the patient eventually recoverd fully. Thus, it is important to recognize that long-term incorrect placement of a catheter may cause deep neck abscess and internal jugular vein thrombosis.
耳鼻咽喉科臨床学会の論文