Ann Geriatr Med Res 2017; 21(3): 142-144  http://dx.doi.org/10.4235/agmr.2017.21.3.142
Recurrent Chylothorax Caused by a Retained Guidewire in a Central Vein: A Case Report
Young-Do Jeon1,2, Eun Kyoung Kim1, Ji-Won Hwang1, Il Park1, Nam-Joon Kim1
1Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 2Division of Cardiology, Department of Medicine, Iksan Hospital, Iksan, Korea
Correspondence to: Young-Do Jeon, MD
Division of Cardiology, Department of Medicine, Iksan Hospital, 969 Muwang-ro, Iksan 54543, Korea
Tel: +82-63-840-9143 Fax:+82-63-840-9458 E-mail: jyd82@naver.com
Received: July 20, 2017; Revised: July 26, 2017; Accepted: September 20, 2017; Published online: September 30, 2017.
© The Korea Geriatrics Society. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The loss of a guidewire occurs very rarely during central venous catheterization (CVC). Guidewire loss can lead to serious mechanical, thrombotic, and infectious complications. A 74-year-old woman was admitted to our institution with dyspnea. Chest computed tomography revealed a guidewire that had remained in a central vein for 3 years, and the patient had extensive central venous thrombosis and a chylothorax. The guidewire and venous thrombus could not be removed because of high perioperative risk due to adhesions and chronic atrophic changes of the intravascular layer. The chylothorax was resistant to conservative treatment. Therefore, the patient was subjected to thoracic duct ligation and embolization. Subsequently, the chylothorax disappeared and the patient was discharged. Physicians should be especially aware of the adverse effects caused by a remnant guidewire and the need for simple chest radiography after CVC.
Keywords: Chylothorax, Central venous catheterization, Venous thrombosis


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