Umbilical venous catheter complication in an infant with left-sided congenital diaphragmatic hernia: extravasation owing to hepatic vein catheterization.
Infants with left-sided congenital diaphragmatic hernia (CDH) are subject to possible intrahepatic placement of the umbilical venous catheter (UVC) during catheterization. A left-sided CDH containing the left lobe of the liver is subject to repositioned anatomy of the umbilical vein, ductus venosus, and hepatic vasculature. This substantially increases the risk of incidentally cannulating the shifted intrahepatic vessels of the liver when placing a UVC. We present a case of hepatic extravasation with line erosion through the liver capsule secondary to UVC placement in an infant with left-sided CDH containing the left lobe of the liver. The patient underwent successful repair of the diaphragmatic defect and is a healthy youngster without complication from CDH or extravasation of the liver capsule. Cannulation of the hepatic vasculature cannot be ruled out with radiograph in infants with left-sided CDH.
Pediatric Surgeons of Phoenix, Phoenix, AZ 85006, USA.
Peter
P
Raisanen
Ian
I
Cassel
Greg
G
Martin
Kathleen
K
Graziano
D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D015505:Chest Tubes; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology*; D005188:False Negative Reactions; D006503:Hepatic Veins / Q000293:injuries*; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000098:blood supply / Q000293:injuries*; D010288:Parenteral Nutrition / Q000295:instrumentation* / Q000379:methods; D011859:Radiography; D016216:Ultrasonography, Prenatal; D014471:Umbilical Veins