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Central venous catheter fracture leading to TPN extravasation and abdominal compartment syndrome diagnosed with bedside contrast-enhanced ultrasound

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Abstract

Central venous lines may require contrast injection under fluoroscopy to evaluate for dysfunction such as occlusion, fibrin sheath development or catheter fracture. Rarely, some patients may be too ill to travel to the interventional radiology suite for this examination. We present a case utilizing contrast-enhanced ultrasound (CEUS) at the bedside to assess catheter integrity in a critically ill infant with a large intra-abdominal fluid collection. CEUS demonstrated extravasation into the collection, confirming catheter fracture and prompting immediate cessation of line use and recommendation for exchange. This case shows the utility of CEUS to evaluate central venous access devices in children who are unable to travel to interventional radiology for a standard contrast injection.

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References

  1. Dariushnia SR, Wallace MJ, Siddiqi NH et al (2010) Quality improvement guidelines for central venous access. J Vasc Interv Radiol 21:976–981

    Article  Google Scholar 

  2. Zens T, Nichol P, Leys C et al (2019) Fractured pediatric central venous catheters — repair or replace? J Pediatr Surg 54:165–169

    Article  Google Scholar 

  3. Hwang FR, Stavropoulos SW, Shlansky-Goldberg RD et al (2008) Tunneled infusion catheter breakage: frequency and repair kit outcomes. J Vasc Interv Radiol 19:201–206

    Article  Google Scholar 

  4. Trerotola SO, Kuhlman JE, Fishman EK (1990) Bleeding complications of femoral catheterization: CT evaluation. Radiology 174:37–40

    Article  CAS  Google Scholar 

  5. Sertic AJ, Connolly BL, Temple MJ et al (2018) Perforations associated with peripherally inserted central catheters in a neonatal population. Pediatr Radiol 48:109–119

    Article  Google Scholar 

  6. Keeney SE, Richardson CJ (2016) Extravascular extravasation of fluid as a complication of central venous lines in the neonate. J Perinatol 15:284–288

    Google Scholar 

  7. Blackwood BP, Farrow KN, Kim S, Hunter CJ (2016) Peripherally inserted central catheters complicated by vascular erosion in neonates. JPEN J Parenter Enteral Nutr 40:890–895

    Article  Google Scholar 

  8. Chebl RB, Kiblawi S, El Khuri C et al (2017) Use of contrast-enhanced ultrasound for confirmation of central venous catheter placement: systematic review and meta-analysis. J Ultrasound Med 36:2503–2510

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA

    Anne Marie Cahill, Fernando Escobar & Michael R. Acord

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  1. Anne Marie Cahill
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  2. Fernando Escobar
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  3. Michael R. Acord
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Correspondence to Michael R. Acord.

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Online Supplementary Material 1

Sagittal dual gray-scale (left) and contrast-mode (right) ultrasound obtained during injection of the right leg tunneled central line with dilute ultrasound contrast. Microbubbles are seen entering the collection, spilling from the region of the right groin (MP4 6772 kb)

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Cahill, A.M., Escobar, F. & Acord, M.R. Central venous catheter fracture leading to TPN extravasation and abdominal compartment syndrome diagnosed with bedside contrast-enhanced ultrasound. Pediatr Radiol 51, 307–310 (2021). https://doi.org/10.1007/s00247-020-04825-8

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  • DOI: https://doi.org/10.1007/s00247-020-04825-8

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