Minimal Symptoms From a 7‐Month Retained Guidewire Following Acute Non‐Tunneled Hemodialysis Catheter Insertion: A Case Report

TL;DR

A guidewire used for hemodialysis was accidentally left in a patient's body for 7 months, causing delayed symptoms and highlighting the need for long-term vigilance after medical procedures.

Contribution

This case report documents a rare, long-term guidewire retention incident and its unexpected presentation as thigh swelling.

Findings

A retained guidewire was discovered 7 months after catheter insertion, causing thigh swelling.

The guidewire spontaneously exited the patient's body before surgery, leaving small residual fragments.

Conservative management was successful, with the patient remaining asymptomatic at 6-month follow-up.

Abstract

Central venous catheterization (CVC), commonly used for hemodialysis due to its rapid access and immediate utility, carries risks—including the rare complication of guidewire retention. While typically identified early, retained guidewires can occasionally go unnoticed and migrate, leading to delayed and unexpected symptoms. This case report describes an unusual instance where a retained guidewire, undetected for 7 months, presented as thigh swelling. The case highlights the importance of sustained clinical vigilance, even long after routine procedures. A 52‐year‐old man with early‐stage chronic kidney disease (CKD) underwent emergency hemodialysis via a non‐tunneled jugular catheter. Seven months later, he developed localized swelling near the right knee. Imaging revealed a fractured guidewire extending from the inferior vena cava (IVC) to the femoral vein. Before the scheduled surgical intervention, the guidewire spontaneously protruded through the skin and was self‐extracted by the patient. Follow‐up imaging showed two small residual fragments, but with symptom resolution, conservative management was chosen. At 6‐month follow‐up, the patient remained asymptomatic.

Figures