Just a 'wee prick' with a needle.
Difficulty with vascular access is a common problem in neonatal medicine and surgery. Recent advances in parenteral therapy/nutrition and manufacture of high quality intravenous lines have enabled smaller infants to survive. Thus, in the small surgical neonate, the insertion of an indwelling intravenous long line (either percutaneously or at cut down) is a frequent occurrence. This procedure is not without its complications and it is thus necessary for the clinician inserting these lines to be aware of this and fully understand the regional anatomy of the area being used. I wish to report an unusual complication which posed several diagnostic and management problems.
Wilson-Storey
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Royal Hospital for Sick Children, Edinburgh, UK.
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002916:Chylothorax / Q000209:etiology / Q000628:therapy; D005260:Female; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D010288:Parenteral Nutrition; D013902:Radiography, Thoracic; D013897:Thoracic Duct / Q000293:injuries