Deep venous thrombosis associated with central venous catheter [Trombosi venosa associata a catetere venoso centrale]

The patient, who had a history of duodenocephalopancreasectomy, came to our attention when she developed bowel occlusion. She underwent emergency bowel resection due to bowel necrosis caused by adhesions. A central venous catheter (CVC) was then positioned in the right internal jugular vein. Since bleeding was recorded from the abdominal drainage, antithrombotic prophylaxis with enoxaparin was started on day 3. On postoperative day 4 the patient's right arm became edematous. A Duplex ultrasound scan (DUS) showed mural thrombosis of the right internal jugular vein. A intravenous infusion of heparin sodium was started. A DUS performed 36 hours later showed recanalization of the vessel was almost complete. The edema in the arm gradually subsided and after 4 days had resolved. Enoxaparin was therefore substituted for heparin sodium. Successive DUS showed complete resolution of the thrombus, and the CVC was removed. Enoxaparin was replaced by warfarin continued for another 2 months.