폐암환자에서 발생한 피하매몰 중심정맥포트 골절 및 색전증 2예
Two Cases of Fractured and Embolized Implanted Central Venous Chemoports in Lung Cancer
김영철 (한중대학교)
김유일 (전남대학교)
나국주 (전남대학교)
김윤현 (전남대학교)
김재규 (전남대학교)
임성철 (전남대학교)
조재영 (전남의대)
임정환 (전남의대)
조계중 (전남의대)
채동렬 (전남의대)
오인재 (전남의대)
김규식 (전남의대)
송상윤 (전남의대)
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초록
항암제 치료 등을 위해서 피하매몰 중심정맥포트를 유치한 환자에서 도관 골절 및 원위부의 색전증은 드물게 발생하는 합병증으로 일반적인 경우는 경피적으로 도관의 제거가 가능하나, 임상의사들이 미리 이러한 합병증을 예측할 수 있는 임상적 및 방사선학적인 소견을 인지하고 조기에 발견하여 올바른 처치를 하는 것이 중요하며, 이러한 합병증을 예방하기 위한 방법 등에 대해서 숙지하는 것이 필요하다.
- keywords
- Chemoport, Pinch-off syndrome, Pinch-off sign, Chemoport, Pinch-off syndrome, Pinch-off sign
Abstract
Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as 'pinch-off syndrome'. 'Pinch-off syndrome' refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter. (Tuberc Respir Dis 2007;63:449-453)
- keywords
- Chemoport, Pinch-off syndrome, Pinch-off sign, Chemoport, Pinch-off syndrome, Pinch-off sign
참고문헌
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