Misplaced permacath dialysis catheter
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Case :
A 63-year-old woman, known case of chronic renal failure was admitted to the hospital for urgent dialysis. Her serum creatinine was 1444 ?mol/L, and her blood urea nitrogen was 48.7 mmol/L. Her serum potassium was 6.2 mmol/L. She was mentally retarded with aggressive behavior. She had had dialysis catheter placed many times which she had pulled out during her bursts of aggressive behavior. Arteriovenous fistula was done one time which also failed. This time she presented without a dialysis catheter. We decided to place a permacath in the operation theater. She was given light general anesthesia. We chose the internal jugular as the vein of choice for the procedure. With the ultrasound, we assessed her internal jugulars. Her previous tunneled catheter which she had pulled out before was in the right internal jugular. This time the right internal jugular could not be visualized at all with ultrasound......

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548422/
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