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Ann Geriatr Med Res > Volume 21(3); 2017 > Article
Annals of Geriatric Medicine and Research 2017;21(3):142-144.
DOI: https://doi.org/10.4235/agmr.2017.21.3.142    Published online September 30, 2017.
Recurrent Chylothorax Caused by a Retained Guidewire in a Central Vein: A Case Report
Young Do Jeon, Eun Kyoung Kim, Ji Won Hwang, Il Park, Nam Joon Kim
1Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jyd82@naver.com
2Division of Cardiology, Department of Medicine, Iksan Hospital, Iksan, Korea.
Correspondence:  Young Do Jeon,
Email: jyd82@naver.com
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.
Key Words: Chylothorax, Central venous catheterization, Venous thrombosis
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