Case report: total parenteral nutrition extravasation associated with spinal cord compression and necrosis.
A preterm infant, whose course was complicated by sepsis, necrotizing enterocolitis with jejunal perforation, intraventricular hemorrhage and cerebellar hemorrhage, suffered permanent and total paralysis below the neck from extravasation of parenteral nutrition fluids through a femoral venous catheter. MRI imaging revealed extravasation of fluid into the paraspinus musculature with extension into the spinal canal. This fluid was identified as hyperalimentation and intralipid. Postmortem examination found evidence of necrosis of the spinal cord as well as perforation of the right iliac vein.
East Carolina University, University Health Systems, Pitt County Memorial Hospital, Greenville, NC 27834, USA. rbknobel@earthlink.net
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RB
Knobel
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Meetze
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Cummings
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D007084:Iliac Vein / Q000293:injuries; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy; D019102:Infant, Very Low Birth Weight; D008297:Male; D009336:Necrosis; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D013116:Spinal Cord / Q000473:pathology; D013117:Spinal Cord Compression / Q000209:etiology*