Case Gallery

Case 1: Retrieval of a lost guidewire from the IVC and right atrium. Ken U. Ekechukwu, MD, MPH, FACP.

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Guidewires can disappear into patients during endovascular interventions such as the insertion of a central venous access. This typically occurs when the operator advances the guidewire and the dilator, sheath, or catheter as a unit, rather than advance these devices over the guidewire. The guidewire is simply a ‘guiding’ tool and should be regarded and […]

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Case 2: Retrieval of a cut central venous catheter from the right atrium. Ken U. Ekechukwu, MD, MPH, FACP.

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Foreign bodies such as guidewires and catheters sometimes break off their parent body and travel through the blood stream to another site. This can happen in the process of removing them from or inserting them into the body. When it happens the embolized pieced should be removed from the body if it is safe to […]

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Case 3: Retrieval of a broken catheter from the right atrium. Ken U. Ekechukwu, MD, MPH, FACP.

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Foreign bodies such as guide wires and catheters sometimes break off and travel through the blood stream from where they were placed originally to another site. When this happens they should be removed from the body if it is safe to do so. This man had the leading end of his central venous catheter pinched […]

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Case 2: Percutaneous decompression of the biliary system. Ken U. Ekechukwu, MD, MPH, FACP.

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Normal drainage of bile may be impaired by cancer, benign strictures, or gallstones that obstruct the biliary pathways and  cause bile to accumulate above the obstruction. This dilates the ducts above the obstruction and forces bile to “leak” into the blood stream, turning the eyes, skin, and urine yellow – biliary jaundice. Biliary malignancy can […]

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Case 3: Percutaneous gastrostomy. Ken U. Ekechukwu, MD, MPH, FACP.

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Sometimes feeding a patient by mouth is impossible or contraindicated, and providing them adequate nutrition becomes a challenge. Substituting oral nutrition with parenteral (intravenous) nutrition is fine when temporary, but not when prolonged; it has its own challenges and complications. In such a situation, a patient can receive a gastrostomy or gastrojejunostomy feeding tube. Providing […]

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