台灣外科醫學會雜誌

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篇名	In-Situ Transection of the Totally Implanted Venous Access System: A Case Report
作者	Dien-Wei Wang, Shu-Lin Wu, Li-Mien Chen
卷期/出版年月	33卷4期 (2000/8)
頁次	194-197
摘要	The totally implanted venous access system has been widely adopted in clinical practice for patients treated with chemotherapy, total parental nutrition and difficult venous route. In-situ transection is a rare complication but may cause disastrous results if not noticed. The incidence is about 0-2.8%. Except for breakage, there has been little discussion on polyurethane catheter fracture. We present a case about the implantation of the polyurethane catheter fracture. We present a case about the implantation of the polyurethane tube device into a 78-year-old male patient with in-situ transection developed two months later. This may be due to an entrapment in the subclavius muscle-costoclavicular ligament complex, which binds or compresses the device during shoulder movement. This problem can be prevented by more lateral clavicle approaching subcalvian vein. If malfunction of the catheter is rule out any breakage or fracture of the system. The "pinch-off" sign and the "fish mouth" deformity are erly x-ray wrnings for impending tear or transection. Immdeiate removal of the device is necessary when such are noticed.
關鍵詞	polyurethrane, catheter, in-situ transection
分類	Case report