title: A case report of abdominal compartment syndrome caused by malposition of a femoral venous catheter.
abstract: BACKGROUND
  Venous catheter malposition is a rare event with potential catastrophic consequences. To our knowledge we describe one of the first case reports of an adult presenting with a rare late complication of femoral venous catheter malposition: abdominal compartment syndrome.
  
  
  METHODS
  A 39 year-old female sustained severe cerebral injury in a road traffic accident. During initial resuscitation a femoral venous catheter was inserted without ultrasound guidance with no immediate concerns. After 48h whilst in intensive care unit the patient developed progressive abdominal distension. Bedside investigations revealed raised intra-abdominal pressures associated with new organ failure. Subsequent an emergency laparotomy and on-table intravenous contrast radiographs revealed extravasation of contrast into the peritoneal space from the malposition of the catheter into the abdominal cavity.
  
  
  CONCLUSIONS
  Complications of central venous catheterization are associated with adverse events with significant morbidity to the patient as well as having cost implications. Mechanical complications are underreported but are potentially preventable through ultrasound-guided insertion, in accordance with international guidelines.
  
  
  CONCLUSIONS
  This case report highlights the importance of safe methods of catheter insertion, the need for increased awareness of late femoral catheter malposition and its potential catastrophic consequences.
authors.affiliation: Blizard Institute, 4 Newark Street, London E1 2AT, United Kingdom. Electronic address: g.pafitanis@qmul.ac.uk.
authors.forename: Georgios
authors.initials: G
authors.lastname: Pafitanis
authors.affiliation: Blizard Institute, 4 Newark Street, London E1 2AT, United Kingdom.
authors.forename: Koulas
authors.initials: K
authors.lastname: Spyridon
authors.affiliation: Blizard Institute, 4 Newark Street, London E1 2AT, United Kingdom.
authors.forename: Evgenia
authors.initials: E
authors.lastname: Theodorakopoulou
authors.affiliation: Blizard Institute, 4 Newark Street, London E1 2AT, United Kingdom.
authors.forename: Katrina
authors.initials: K
authors.lastname: Mason
authors.affiliation: Blizard Institute, 4 Newark Street, London E1 2AT, United Kingdom.
authors.forename: Olga
authors.initials: O
authors.lastname: Ygropoulou
authors.affiliation: Blizard Institute, 4 Newark Street, London E1 2AT, United Kingdom.
authors.forename: Ourania
authors.initials: O
authors.lastname: Mousafiri
keywords: Abdominal compartment syndrome; Femoral vein catheter; Malposition of central venous catheter