Spontaneous migration of a Port-a-Cath catheter into ipsilateral jugular vein in two patients with severe cough.
Port-A-Cath systems are widely used for long-term therapy in the treatment of malignancies and infection. Spontaneous migration of Port-A-Cath catheters after satisfactory initial placement is uncommon but is associated with a number of complications, including neck pain, shoulder pain, ear pain, infection, venous thrombosis, and neurological complications. We describe two cases of migration of the Port-A-Cath catheter into the ipsilateral internal jugular vein. Both received surgical reposition of the catheter with a longer one. We speculate that the migration is related to severe cough and vigorous changes of intrathoracic pressure. We also review the literature regarding such unusual complications of Port-A-Cath. Because catheter migration might be asymptomatic, monitoring the catheter position bimonthly when not used is recommended. Before a new course of chemotherapy or encountering symptoms of migration, obtaining a chest roentgenogram is essential to provide early detection and repositioning management of a migrated catheter.
Wu
Pei-Yu
PY
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Yeh
Yu-Chang
YC
Huang
Chi-Hsiang
CH
Lau
Hon-Ping
HP
Yeh
Huei-Ming
HM
D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003371:Cough / Q000150:complications*; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007601:Jugular Veins; D008297:Male; D011859:Radiography; D012086:Reoperation; D014683:Vena Cava, Superior