Iatrogenic lymphocutaneous fistula secondary to right-sided pheresis catheter placement and its percutaneous treatment: a case report

J Vasc Access. 2017 Jul 14;18(4):e45-e47. doi: 10.5301/jva.5000732.

Abstract

We present a case of an iatrogenic lymphocutaneous fistula secondary to placement of a tunneled, large bore (14.5 Fr) right-sided internal jugular vein for plasmapheresis to treat antibody-mediated kidney transplant rejection. While iatrogenic lymphatic leaks caused by neck and thoracic surgeries are well described in the literature, lymphatic leak or lymphocutaneous fistula resulting from image-guided placement of a central venous catheter through the right internal jugular vein has yet to be described. We also describe the successful percutaneous treatment of this lymphocutaneous fistula using a combination of n-butyl cyanoacrylate glue and embolization coils.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cutaneous Fistula / diagnosis
  • Cutaneous Fistula / etiology
  • Cutaneous Fistula / therapy*
  • Embolization, Therapeutic* / instrumentation
  • Embolization, Therapeutic* / methods
  • Enbucrilate / administration & dosage
  • Equipment Design
  • Female
  • Fistula / diagnosis
  • Fistula / etiology
  • Fistula / therapy*
  • Humans
  • Iatrogenic Disease*
  • Lymphatic Diseases / diagnosis
  • Lymphatic Diseases / etiology
  • Lymphatic Diseases / therapy*
  • Plasmapheresis / adverse effects*
  • Plasmapheresis / instrumentation*
  • Treatment Outcome
  • Vascular Access Devices / adverse effects*

Substances

  • Enbucrilate