Abstract
Calcified catheter “cast” found on radiologic studies after central venous catheter removal is a rare complication that has been reported twice. Both cases were associated with thrombus. In this case report, we present a 15-year-old boy with acute lymphoblastic leukemia who demonstrated on CT scan a radiopacity in his left brachiocephalic vein after removal of an implanted venous access device. This was initially thought to be a retained catheter fragment. Diagnostic studies, including venogram, excluded the presence of a retained catheter fragment. Additional procedures to retrieve a nonexistent catheter fragment were thus avoided. Therefore, a catheter “cast” should be considered as part of the differential diagnosis when calcification is found on an imaging study after removal of an implantable venous access device to prevent an unwarranted surgical exploration.
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Bellini F, Beluffi G, Principi N (1984) Total intravenous hyperalimentation (TIH) complications in childhood: a radiological survey. Pediatr Radiol 14:6–10
Anderson MAB, Poenaru D, Kamal I (1998) Calcified catheter ‘cast’: a rare complication of indwelling central venous catheters in infants. Pediatr Surg Int 13:610–612
Casado-Flores J, Barja J, Martino R, Serrano A, Valdivielso A (2001) Complications of central venous catheterization in critically ill children. Pediatr Crit Care Med 2:57–62
Babu R, Spicer RD (2002) Implanted vascular access devices (ports) in children: complications and their prevention. Pediatr Surg Int 18:50–53
Deerojanawong J, Sawyer SM, Fink AM, Stokes KB, Robertson CF (1998) Totally implantable venous access devices in children with cystic fibrosis: incidence and type of complications. Thorax 53:285–289
Krul EJ, Leeuwen EF, Vos A, Voute PA (1986) Continuous venous access in children for long-term chemotherapy by means of an implantable system. J Pediatr Surg 21:689–690
Golladay ES, Mollitt DL (1986) Percutaneous placement of a venous access port in a pediatric patient population. J Pediatr Surg 21:683–684
Yen H, Hwang B, Lee P, Meng CCL (2006) Transcatheter retrieval of different types of central venous catheter fragment: experience in 13 cases. Angiology 57:347–353
Jones SA, Giacomantonio M (2003) A complication associated with central line removal in the pediatric population: retained fixed catheter fragments. J Pediatr Surg 38:594–596
De Carolis MP, Costa S, Polimeni V, Di Stasi C, Papacci P, Romagnoli C (2006) Successful removal of catheter fragment from right atrium in a premature infant. European Journal of Pediatrics doi:10.1007/s00431-006-0275-0
Ehrlich PF, Lamkin T (2001) Unusual delayed complication of central venous access. J Pediatr Hematol 23:472–473
Spencer K, Weinert L, Pentz WH (1999) Calcified right atrial mass in a woman receiving long-term intravenous phosphate therapy. J Am Soc Echocardiogr 12:215–217
Watts MA, Innes BJ (1984) Calcified atrial thrombus: complication of central venous hyperalimentation. Tex Heart Inst J 11:76–79
Tarantino MD, Vasu MA, Drak TH, Crowe PC, Udall JH (1991) Calcified thrombus in the right atrium: a rare complication of long-term parenteral nutrition in a child. J Pediatr Surg 26:91–93
Mitchell LG, PARKAA Group (2003) A prospective cohort study determining the prevalence of thrombotic events in children with acute lymphoblastic leukemia and a central venous line who are treated with l-asparaginase. Cancer 97:508–516
Smallwood RA, Davidson JS (1968) Calcification in the portal system. Gastroenterology 54:265–270
Broker MH, Baker SR (1985) Calcification in the portal vein wall demonstrated by computed tomography. J Comput Assist Tomogr 9:444–446
Egiebor O, Flowers C, Gilkey S, Langer BG (1995) Calcifications of portal venous system wall: CT findings in three patients. Abdom Imaging 20:477–479
Rizzo AJ, Haller JO, Mulvihill DM, Cohen HL, Da Silva MG (1989) Calcification of the ductus venosus: a cause of right upper quadrant calcification in the newborn. Radiology 173:89–90
Ablow RC, Effman EL (1972) Hepatic calcifications associated with umbilical vein catheterization in the newborn infant. Am J Roentgenol Radium Ther Nucl Med 114:380–385
Fuenfer MM, Georgeson KE, Cain WS, Colvin EV, Johnson WH Jr, Pearce FB, McMahon WS (1998) Etiology and retrieval of retained central venous catheter fragments within the heart and great vessels of infants and children. J Pediatr Surg 33:454–456
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Sabbaghian, M.S., Rivera, R., Ginsburg, H.B. et al. Calcified catheter “cast” masquerading as a retained catheter fragment after removal of an implanted venous access device. Pediatr Surg Int 23, 927–930 (2007). https://doi.org/10.1007/s00383-007-1911-0
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DOI: https://doi.org/10.1007/s00383-007-1911-0