Background: Hypovolemic shock in a young woman warrants urgent diagnosis of the etiology and management. A quick intravascular access helps in replenishing some vascular volume while the laboratory and radiologic investigations are underway. Inability to gain a peripheral access would warrant the use of femoral, jugular, or supraclavicular veins for the purpose. Case: A rare case of erratic femoral venous catheter placement in a 35-year-old tubectomized woman in a state of hypovolumic shock that resulted in iatrogenic hemoperitoneum unresponsive to transfusion and worsening of general condition is presented and discussed. Results: Laparotomy was performed, at which all abdominal and pelvic viscera were normal. The femoral catheter was removed and the abdomen closed. The postoperative period was uneventful. Conclusions: Failure of vital signs to improve soon after the initiation of therapy for shock should arouse suspicion of catheter displacement, even after correct initial placement. (J GYNECOL SURG 30:124)
Get full access to this article
View all access options for this article.
References
1.
LubnerM, MeniasC, RuckerC, BhallaS, PetersonCM, WangL, GratzB. Blood in the belly: CT findings of hemoperitoneum. Radiographics, 2007; 27:109.
2.
KarapinarB, CuraA. Complications of central venous catheterization in critically ill children. Pediatr Int, 2007; 49:593.
3.
EisenLA, NarasimhanM, BergerJS, et al. Mechanical complications of central venous catheters. J Intensive Care Med, 2006; 21:40.
4.
SeldingerSI. Catheter replacement of the needle in percutaneous arteriography: A new technique. Acta Radiol, 1953; 39:368.
5.
EannielloVC11, JacobsLM, SahdevP. Intraperitoneal femoral venous catheter insertion with free blood return in presence of tense hemoperitoneum. Am J Emerg Med, 1991; 9:157.
