Abstract
Introduction: The use of central venous catheter is a common practice in hemodialysis in Mali. Its use exposes to risks such as infection, stenosis, thrombosis among others. Pulmonary embolism is a rare but serious complication. The aim of our work was to offer advice on the diagnosis, risk factors, treatment and prevention of deep vein thrombosis following the placement of a central catheter. Observation: This was a 56-year-old woman, a housewife living in the city of Bamako. She had been on chronic hemodialysis for 6 months due to nephroangiosclerosis, at a rate of two four-hour sessions per week through a right femoral catheter. Before her hospitalization, she had a fever, physical asthenia, anorexia, a feeling of heavy leg on the right and abdominal pain. The clinical examination found a conscious patient, with little color and normal parameters, a swelling of the right leg with pain and redness. The biological assessment revealed hypochromic microcytic anemia, Procalcitonin at 2.75ng/l. The Doppler of the right lower limb confirmed deep vein thrombosis. The pulsed cardiac Doppler and the ECG confirmed the diagnosis of pulmonary embolism. Curative treatment of venous thrombosis was started. The immediate aftermath was marked by respiratory problems requiring oxygen therapy, acute circulatory failure syndrome with coldness of the extremities. The outcome was unfavorable with the death of the patient. Conclusion: The use of central venous catheter for hemodialysis as first-line treatment remains frequent in Mali. Patients should benefit from increased monitoring and prophylactic treatment to prevent the occurrence of thromboembolic events.
Published Version
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