Extravasation of total parenteral nutrition into the liver from an upper extremity peripherally inserted central venous catheter

Article type: Case Report

Authors: Gupta, Arpit^{a; b} | Bhutada, Alok^b | Yitayew, Miheret^b | Rastogi, Shantanu^{b; *}

Affiliations: [a] Division of Neonatology, Maimonides Infants and Children’s Hospital, Brooklyn, NY, USA | [b] Division of Neonatology, NYU School of Medicine, New York, NY, USA

Correspondence: [*] Address for correspondence: Shantanu Rastogi, MD, MMM, Albert Einstein College of Medicine, Maimonides Infant and Children’s Hospital, 4802 Tenth Ave, K-113, Brooklyn, NY 11219, USA. Tel.: +1 718 283 8853; E-mail: srastogi@maimonidesmed.org.

Abstract: Peripherally inserted central catheters (PICC) are the mainstay of central venous access in preterm infants, and one of the common procedures performed in neonatal intensive care unit (NICU). Complications of PICC include infection, mechanical dysfunction, thrombosis, migration, and extravasation of the infusate. In this report, we describe a case of PICC inserted from an upper extremity with migration into the inferior vena cava (IVC) and the hepatic vein associated with extravasation of the total parenteral nutrition (TPN) into the peritoneum and the liver. This case highlights the vigilance required not only to insert but for the maintenance of PICC to prevent complications associated with migration of PICC.

Keywords: Preterm infant, PICC, central catheter, hyperalimentation, malposition, liver abscess, necrotizing enterocolitis

DOI: 10.3233/NPM-181726

Journal: Journal of Neonatal-Perinatal Medicine, vol. 11, no. 1, pp. 101-104, 2018