An unusual complication of central venous catheterization

Lymphorrhea: An unusual complication of jugular venous catheterization for hemodialysis

“…[ 8 ] Furthermore, instead of the usual termination at the posterolateral aspect of the venous angle, anterolateral termination can occur. [ 8 ] These variations pave the way for inadvertent lymphatic disruption, likelihood of which increases with history of multiple catheter placements, more needle passes, difficulty in proceeding the guide wire,[ 2 ] and in patients with severe pulmonary hypertension. [ 3 ] However, in our case, none of the above factors were present.…”

“…Use of real-time ultrasound (US) guidance has decreased the rate of complications and improved the initial technical success rates. [ 1 ] Lymphatic disruption has been frequently reported, complicating the insertion of central lines,[ 2 3 ] pacemakers,[ 4 ] and thoracic and neck surgeries (chylous fistula occurring in 1%–2% of comprehensive neck dissections[ 5 ]) but has been rarely reported with hemodialysis (HD) catheters. [ 6 7 ] We report a rare case of lymphorrhea complicating insertion of left internal jugular vein (IJV) TCC insertion under US guidance, which was managed without catheter removal.…”