Department of Paediatrics, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Department of Paediatrics, Neonatology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
J Coll Physicians Surg Pak. 2022 Dec;32(12):SS178-SS180. doi: 10.29271/jcpsp.2022.Supp0.SS178.
Umbilical venous catheterisation is a common bedside procedure in the neonatal intensive care unit (NICU). Complications including thrombus formation, thromboembolism, vessel perforation, haemorrhage, and central line-associated bloodstream infection can be seen after the procedure. Pyogenic liver abscess is a rare but life-threatening complication of umbilical venous catheterisation. A male infant with cyanotic congenital heart disease was admitted to NICU. An umbilical venous catheter (UVC) was inserted. Abdominal X-ray showed an improperly positioned UVC, it was removed and replaced with a newer one. On the seventh day, the infant had abdominal distension and his clinical condition deteriorated. Abdominal ultrasonography (US) revealed a hepatic abscess. US-guided percutaneous abscess drainage was performed. Empiric antibiotic treatment was initiated and culture revealed Staphylococcus. The patient was followed by serial US and the lesion was completely resolved after three weeks. In conclusion, clinical worsening associated with gastrointestinal symptoms in a cyanotic infant with UVC should raise suspicion for liver abscess. Key Words: Neonate, Hepatic abscess, Umbilical venous catheter, Cyanotic heart disease.
脐静脉置管术是新生儿重症监护病房(NICU)中的常见床边操作。该操作后可能会出现血栓形成、血栓栓塞、血管穿孔、出血和与中心静脉导管相关的血流感染等并发症。化脓性肝脓肿是脐静脉置管术的一种罕见但危及生命的并发症。一名患有发绀性先天性心脏病的男性婴儿被收入 NICU。进行了脐静脉导管(UVC)置管术。腹部 X 光片显示 UVC 位置不当,将其取出并更换为更新的导管。第 7 天,婴儿出现腹胀,临床状况恶化。腹部超声(US)显示肝脓肿。进行了超声引导下经皮脓肿引流。经验性抗生素治疗开始,培养显示为葡萄球菌。通过连续的超声检查对患者进行了随访,三周后病变完全消退。总之,发绀的 UVC 婴儿出现胃肠道症状相关的临床恶化应引起对肝脓肿的怀疑。关键词:新生儿、肝脓肿、脐静脉导管、发绀性心脏病。