Ultrasound-guided central venous puncture in an obese patient with cervical adenomegaly.

BACKGROUND AND OBJECTIVES Classical central venous techniques are based on superficial anatomical references and the knowledge of the vascular anatomy of the area to be punctured. The ultrasound allows direct vision of vascular and perivascular structures, and the needle during the procedure. The objective of this report was to describe an ultrasound-guided central venous catheter placement in an obese patient with adenomegaly. CASE REPORT This is a 28 years old white male patient, with 1.70 m, weighing 120 kg, with the diagnosis of nodular sclerosis Hodgkin's lymphoma. An ultrasound-guided internal jugular vein catheter placement was requested to the Anesthesiology Department of the Hospital Governador Celso Ramos due to the presence of a supraclavicular node that would hinder the anatomical reference for the puncture in an obese patient. After obtaining the best image, the left internal jugular vein was punctured and a triple lumen catheter was introduced. It was necessary only a single puncture and the catheter was easily introduced; no complications developed during the procedure.