Anderson M A, Poenaru D, Kamal I
166 Brock Street, Hotel Dieu Hospital, Kingston, Ontario K7L 5G2, Canada.
Pediatr Surg Int. 1998 Oct;13(8):610-2. doi: 10.1007/s003830050418.
Peri-catheter calcification is an unusual and previously unreported complication of central venous (CV) catheterization in infants. A 1. 9 Fr Silastic CV catheter was placed in a term infant for administration of total parenteral nutrition and antibiotics following intra-abdominal sepsis. The catheter was removed, without complication, at a later date after another septic episode. Imaging studies performed in the investigation of a possible intra-abdominal abscess revealed a cylindrical density within a clot in the inferior vena cava (IVC). The density was presumed to be a retained catheter fragment. Further investigation indicated total occlusion of the IVC. Surgical exploration of the IVC revealed only a calcified thrombus. This case represents a rare and previously unreported complication of CV catheterization in infants. Diagnosing this condition on radiographic evidence alone can be difficult. It is hoped that awareness of the potential for this complication will avoid unnecessary invasive procedures in the future. We also suggest a high level of clinical suspicion and routine Doppler ultrasound investigations to detect IVC thrombosis when indwelling CV catheters are used in infants.
导管周围钙化是婴儿中心静脉置管一种罕见且此前未被报道过的并发症。一名足月儿因腹腔内脓毒症接受全胃肠外营养和抗生素治疗而置入了一根1.9F的硅橡胶中心静脉导管。在另一次脓毒症发作后的晚些时候，导管被拔除，未出现并发症。在对可能的腹腔内脓肿进行检查时所做的影像学研究显示，下腔静脉内的血凝块中有一个圆柱形致密影。该致密影被推测为残留的导管碎片。进一步检查表明下腔静脉完全闭塞。对下腔静脉进行手术探查仅发现了一个钙化血栓。该病例代表了婴儿中心静脉置管一种罕见且此前未被报道过的并发症。仅依靠影像学证据诊断这种情况可能很困难。希望对这种并发症可能性的认识能避免未来不必要的侵入性操作。我们还建议，当在婴儿中使用留置中心静脉导管时，要保持高度的临床怀疑并进行常规多普勒超声检查以检测下腔静脉血栓形成。
