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Caval replacement with parietal peritoneum tube graft for septic thrombophlebitis after hepatectomy: A case report

World Journal of Hepatology 2019年第1期11卷 133-137页

作者： Charlotte Maulat Léopoldine Lapierre Isabelle Migueres Xavier Chaufour Guillaume Martin-Blondel Fabrice Muscari Digestive Surgery Toulouse UniversityHospital Department of Infectious and Tropical Diseases Toulouse-Purpan University Hospital Vascular Surgery Department Toulouse-Rangueil University Hospital

BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a *** SUMMARY This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy,the patient's condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this *** Septic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction.

关键词： Bilioma Septic thrombophlebitis Septicaemia Parietal peritoneum tube graft Complete caval reconstruction Case report

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Biomechanical aspects of catheter-related thrombophlebitis

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Journal of Biomedical Science and Engineering 2013年第12期6卷 6-13页

作者： Oren Moshe Rotman Dalit Shav Sagi Raz Uri Zaretsky Shmuel Einav Department of Biomedical Engineering Tel Aviv University Tel Aviv Israel

Short peripheral catheters (SPCs) are the most common intravenous devices used in medical practice. Short peripheral catheter thrombophlebitis (SPCT) is the most frequent complication associated with SPCs, causing discomfort and usually leading to removal of the catheter and insertion of a new one at a different site. The aim of this research was to explore whether biomechanical factors, in addition to biochemical factors, also play a role in the formation of thrombophlebitis. Hence, two of the biomechanical aspects of SPCT were investigated: the physical pressure load exerted by the SPC on the endothelial monolayer, and disturbances in the flow patterns due to the SPC. Endothelial activation was studied by subjecting human umbilical vein endothelial cells (HUVEC) to a weight load of SPC pieces and measuring the release profile of von-Willebrand Factor (vWF) over time, using ELISA. vWF release was chosen as the measure for endothelial activation since it was the major component of the Weibel-Palade Bodies (WPBs), which underwent exocytosis by endothelial cells during activation. Flow patterns were analyzed on a 3D computational fluid dynamics (CFD) model of a brachiocephalic vein with SPC. vWF release profiles were significantly higher in the HUVECs subjected to the load, indicating HUVEC activation. CFD simulations demonstrated a decrease in flow velocities along the catheter body, between the catheter and the vein, due to an enlarged boundary layer. Results indicate that the contact region between the SPC body and the vein wall can be partially responsible for SPCT development, and inflammatory and coagulatory processes initiated by stimulated endothelial cells may be amplified due to disturbed blood flow.

关键词： Endothelial Activation vWF thrombophlebitis Phlebitis Short Peripheral Catheters Infusion Intravenous Access CFD

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Septic Superficial Femoral Vein thrombophlebitis Causing Pulmonary Emboli and Respiratory Failure: Case Report and Review of the Literature

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International Journal of Clinical Medicine 2019年第8期10卷 413-420页

作者： Ziad Fayad Paul Guentert Erin Rissler Nuha Zackariya Shivani Patel Ali Sualeh Mahmoud Al-Fadhl Sufyan Zackariya Grant Wiarda Mallory Martin Joseph Lake Sarah Philbrick Mark Walsh General and Vascular Surgery X-Ray Consultants South Bend IN USA Saint Joseph Regional Medical Center Mishawaka IN USA St. Luc Family Hospital Tabarre Haiti Indiana University School of Medicine South Bend Campus South Bend IN USA

Septic pulmonary emboli rarely cause respiratory failure that requires mechanical ventilation. The most common causes of septic pulmonary emboli are related to intravenous drug abuse, indwelling intravenous catheters, endocarditis and septic pelvic thrombophlebitis. In addition, soft tissue injury-related thrombophlebitis rarely causes septic pulmonary emboli. We describe a unique case of a 43-year-old man who developed septic thrombophlebitis of the femoral vein following soft tissue injury from trauma to the shin with ensuing septic pulmonary emboli which necessitated endotracheal intubation and mechanical ventilation. The patient required mechanical ventilation for eleven days, developed empyema and grew out methicillin-resistant Staphylococcus aureus on blood cultures. A transesophageal echocardiogram was normal, and there was no indication of bacterial endocarditis. In addition to eleven days of mechanical ventilation, the patient was treated with intravenous heparin, cefepime and clindamycin. These medications were then discontinued and the patient was treated with weight-adjusted vancomycin. Following the return of cultures, the patient was treated for six weeks with ceftaroline 600 mg IV twice a day. In addition, the patient received bilateral thoracentesis followed by chest tube drainage until resolution of the pleural effusions. The patient made a complete recovery. We describe this case and the implications for differential diagnosis and treatment of these two uncommon conditions.

关键词： Septic thrombophlebitis Pulmonary Emboli Respiratory Failure Critical Care

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Efficacy of Infliximab Therapy for a Patient with Superficial thrombophlebitis and Rheumatoid Arthritis

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International Journal of Clinical Medicine 2011年第4期2卷 459-462页

作者： Masahiro Tada Kazuyoshi Fukai Tadashi Okano Yuko Sugioka Shigeyuki Wakitani Hiroaki Nakamura Tatsuya Koike Department of Orthopaedic Surgery Osaka City University Medical School Department of Dermatology Osaka City University Medical School

Superficial thrombophlebitis is known as a frequent complication of Beh?et’s disease. Infliximab may promote healing of superficial thrombophlebitis in patients with Beh?et’s disease. However, thrombophlebitis as a complication of rheumatoid arthritis (RA) is rare and treatments have not been reported. We describe the case of a 47-year-old man with RA with complications of superficial thrombophlebitis who was treated using methotrexate and infliximab. Erythema nodosum and cord-like induration with pain in the extremities completely disappeared following a single infusion of infliximab and oral acetylsalicylic acid was not needed. This case suggests that infliximab might offer effective treatment for patients showing superficial thrombophlebitis with RA.

关键词： Infliximab Superficial thrombophlebitis Treatment Rheumatoid Arthritis Tumor Necrosis Factor α

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Phlebosclerosis: An overlooked complication of varicose veins that affects clinical outcome: A case report

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World Journal of Clinical Cases 2023年第35期11卷 8404-8410页

作者： Shi-Yan Ren Song-Yi Qian Rong-Ding Gao Department of Laser and Vascular Surgery Aviation General HospitalBeijing 100012China Department of Cardiac Surgery Zhongshan Hospital(Xiamen Branch)Fudan UniversityXiamen 361015Fujian ProvinceChina

BACKGROUND Phlebosclerosis is a common age-related fibrotic degeneration of the venous *** is a disorder rather than a disease,which may cause venous dysfunction and even venous *** is rarely reported in patients with varicose *** SUMMARY The present report describes the case of a 70-year-old man with varicose veins,vitiligo,and *** angiography revealed blood reflux in the superficial and deep *** patient underwent surgery to remove the saphe-nous *** the operation,a calcified vein resembling a wooden stick was found,which was surprisingly extracted from the thickened venous wall.A cross-section of this wooden stick-like vein revealed venous fibrosis and calcification,obvious thickening of the venous wall,extensive collagen deposition on the venous wall,hyaline degeneration,and venous sclerosis causing closure of the venous *** This is probably the first report of a wooden stick-like structure being found in the venous wall in patients with varicose veins and venous *** can be observed in the late stage of varicose veins complicated by frequent infections and worse clinical ***,it is important to be aware of this condition and address it rather than overlook it.

关键词： Phlebosclerosis Varicose vein Phlebothrombosis thrombophlebitis Calcification Ossification of vein wall Chronic venous disease Case report

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Treating Principles and Methods of Traditional Chinese Medicine in Treatment of Peripheral Vascular Diseases

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Journal of Traditional Chinese Medicine 2001年第2期21卷 130-133页

作者：张雅洁陈知行刘玉洁张雅琳 ~1Qiqihaer Municipal TCM Hospital Heilongjiang province161000 ~2Qiqihaer Second Hospital Heilongjiang province

Peripheral vascular disease embraces a variety of conditions such as thromboangiitis obliterans, Raynaud's disease, thrombophlebitis, aorto-arteritis, obliterate atherosclerosis, varix or phlebothrombosis of the lower limb. Although the affected blood vessel may be arterial or venous one and caused either by inflammation or degenerate changes, they share common symptoms and signs, such as blood stasis, ischemia, thrombosis, ecchymosis, swelling, constriction or obliteration of blood vessels due to circulatory impairment. Since they share common characteristics, the treating principles and methods will be discussed as follows.

关键词： Diagnosis, Differential Drugs, Chinese Herbal Female Humans Male Medicine, Chinese Traditional Raynaud Disease Thromboangiitis Obliterans thrombophlebitis

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A Prospective Study to Compare Routine versus Need Based Change of IV Cannula on Development of Infusion Phlebitis in Adult Surgical Patients

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Journal of Health Science 2017年第5期5卷 251-262页

作者： Divyanti Mishra Kumar Nishant Central Referral Hospital Gangtok 73 7102 lndia

（IV） Intravenous therapy is one of the most commonly performed procedures in hospitalized patients yet phlebitis affects 27% to 70% of all patients receiving IV therapy. The incidence of phlebitis has proved to be a menace in effective care of surgical patients, delaying their recovery and increasing duration of hospital stay and cost. The recommendations for reducing its incidence and severity have been varied and of questionable efficacy. The current study was undertaken to evaluate whether elective change of IV cannula at fixed intervals can have any impact on incidence or severity of phlebitis in surgical patients. All patients admitted to the Department of Surgery, SMIMS undergoing IV cannula insertion, fulfilling the selection criteria and willing to participate in the study, were segregated into two random groups prospectively： Group A wherein cannula was changed electively after 24 hours into a fresh vein preferably on the other upper limb and Group B wherein IV caunula was changed only on development of phlebitis or leak i.e. need-based change. The material/brand and protocol for insertion of IV cannula were standardised for all patients, including skin preparation, insertion, fixation and removal. After carmulation, assessment was made after 6 hours, 12 hours and every 24 hours thereafter at all venepuncture sites. VIP and VAS scales were used to record phlebitis and pain respectively. Upon analysis, though there was a lower VIP score in group A compared to group B （0.89 vs. 1.32）, this difference was not statistically significant （p-value = 0.277）. Furthermore, the differences in pain, as assessed by VAS, at the site of puncture and along the vein were statistically insignificant （p-value 〉 0.05）. Our results are in contradiction to few other studies which recommend a policy of routine change of carmula. Further we advocate a close and thorough monitoring of the venepuncture site and the length of vein immediately distal to the puncture site, as well as a

关键词： IV cannula thrombophlebitis infusion phlebitis cohort study

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Non-Infectious Complications of Non-Tunneled Central Venous Catheterization for Hemodialysis: Incidence and Reasons in Ouagadougou (Burkina Faso)

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Open Journal of Nephrology 2016年第1期6卷 1-9页

作者： Gérard Coulibaly Gildas Ilboudo Adama Roger Karambiri François P. Kissou Adama Lengani Department of Nephrology and Hemodialysis Yalgado Ouedraogo University Hospital Center (YO-UHC) Ouagadougou Burkina Faso

Goal: Evaluate the importance and reasons of non-infectious complications of non-tunneled central venous catheterization in our hemodialysis unit. Patients and methods: The study, a prospective type, was conducted in the department of nephrology and hemodialysis of Yalgado Ouedraogo University Hospital Center (YO-UHC) in Ouagadougou, Burkina Faso, from 15 February to 30 June 2015. Patients in whom a new central venous catheter (CVC) was inserted during the study period were included. Catheterization-related complications were noted. Results: During the study period, 156 CVCs (9 per week) were placed in femoral (56.4%), internal jugular (40.4%) or subclavian vein (3.2%). There were 114 patients (59.7% of men and 40.3% of women), average age 41.8 ± 17.1 years, low socio-economic level in 64% of cases. At least a non-infectious complication was observed in 67 cases representing 42.9%. They were: puncture failure (40%), arterial puncture (12.2%), puncture of the thoracic duct (1.3%), pneumothorax (1.3%), bleeding related to the catheter insertion (5.8%), hematoma (1.3%), opposite direction (0.6%), dysfunction of the CVC (10.3%), femoralthrombophlebitis (3.2%). Conclusion: Non-infectious complications of non-tunneled central venous catheterization in our hemodialysis unit were frequent and sometimes severe. Their common denominator was the absence of ultrasound guidance. Our study reaffirms the need for equipping with Doppler ultrasound in our hemodialysis units, even in developing countries, for better security of the patient during central venous catheterization.

关键词： Burkina Faso Catheterization Complication Hemodialysis Pneumothorax thrombophlebitis

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Reducing the Prevalence of Catheter-Related Infections by Quality Improvement: Six-Year Follow-Up Study

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Open Journal of Nursing 2016年第2期6卷 79-87页

作者： Dan Malm Bo Rolander Eva-Marie Ebefors Lisa Conlon Annette Nygårdh Department of Nursing School of Health and Welfare J&oumlnk&oumlping University J&oumlnk&oumlping Sweden Department of Internal Medicine County Hospital Ryhov J&oumlnk&oumlping Sweden Futurum Academy for Healthcare J&oumlnk&oumlping Sweden Department of Behavioral Science and Social Work School of Health and Welfare J&oumlnk&oumlping University J&oumlnk&oumlping Sweden

Background: Peripheral venous catheter (PVC) insertion is a crucial nursing action during life support. Several factors that increase the risk of thrombophlebitis associated with PVCs have been reported. Objective: We wish to evaluate the impact of a quality improvement regarding PVC treatment for patients with coronary heart diseases. Method: A longitudinal, quantitative observational study was carried out in 2008 and 2013 in a hospital in southern Sweden with 360 consecutive patients suffering from acute chest pain. New routines for PVC treatment were included in the hospital with daily inspection according to a checklist. A structured observation protocol was used to survey the prevalence of thrombophlebitis between 2008 and 2013. Also, we examined the relationship between the location and luminal diameters of PVCs. Results: The student’s t-test showed significant differences between 2008 and 2013 with respect to luminal diameter of PVCs (p = 0.002), prevalence of thrombophlebitis (p = 0.003) and number of days with PVC left in situ (p < 0.001). Conclusion: These findings emphasize the value of using systematic daily inspections and checklists to achieve quality and safety in patients with acute chest pain having PVC-based treatment.

关键词： Bloodstream Infection Peripheral Venous Catheter Quality Improvement thrombophlebitis

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A Case Report of Lemierre’s Syndrome with Multisystem Dysfunction in the Setting of COVID-19 Exposure in a Pediatric Patient

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Case Reports in Clinical Medicine 2021年第9期10卷 246-251页

作者： Kathleen McMahon Odiraa Nwankwor Christina Palladino Laura Czulada Cameron Jacobs Department of Emergency Medicine St. Luke’s University Health Network Bethlehem PA USA Department of Pediatric Critical Care St. Luke’s University Health Network Bethlehem PA USA

A 17-year-old male with no significant past medical history presented to the emergency department with severe sepsis of unknown etiology. The patient was found to have septic thrombophlebitis of the internal jugular vein with multiorgan dysfunction and septic embolization to both lungs. The patient was also noted to have COVID-19 IgM antibodies and multiple close COVID-19 exposures prior to the patient’s emergency department presentation. Here, we present the prolonged and complicated hospitalization of this patient and a review of this rare but important disease.

关键词： Lemierre’s Syndrome Sepsis COVID-19 thrombophlebitis Septic Embolism

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