Wu Pei-Yu, Yeh Yu-Chang, Huang Chi-Hsiang, Lau Hon-Ping, Yeh Huei-Ming
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Ann Vasc Surg. 2005 Sep;19(5):734-6. doi: 10.1007/s10016-005-4638-1.
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.
输液港系统广泛应用于恶性肿瘤和感染的长期治疗。输液港导管在初始放置满意后自发移位并不常见，但会引发多种并发症，包括颈部疼痛、肩部疼痛、耳部疼痛、感染、静脉血栓形成和神经并发症。我们描述了两例输液港导管移位至同侧颈内静脉的病例。两例均接受了导管更换为更长导管的手术复位。我们推测这种移位与剧烈咳嗽和胸腔内压力的剧烈变化有关。我们还回顾了有关输液港此类异常并发症的文献。由于导管移位可能无症状，建议在未使用时每两个月监测一次导管位置。在开始新的化疗疗程之前或出现移位症状时，进行胸部X线检查对于早期发现和处理移位导管至关重要。
