Unusual clot formation following insertion of central double lumen catheter for hemodialysis.

We report a case of a patient with chronic renal failure (CRF) due to fibrillary glomerulonephritis, who was admitted to our Hospital for fever accompanied by chills of two days’ duration. Due to aggravation of his CRF, accompanied by severe metabolic acidosis, an internal jugular double lumen central vein catheter was inserted, through which he was hemodialyzed. Transthoracic and transesophageal echocardiography revealed a clot in the right atrium with an abnormal circumference, connected to the tip of the catheter. The case is presented in order to illustrate the significant contribution of transesophageal echocardiography to the non-invasive detection of a clot in the right atrium and to the choice of appropriate therapeutic management in saving the patient’s life. The transesophageal echocardiogram provides invaluable information concerning the evolution, development and regression of right atrium clots formed at the tip of jugular catheters.