Introduction. The Hickman catheter is a tunneled, open-type catheter often
implanted in children for long-term intravenous treatment. Their application
can cause numerous complications. Catheter breakage and dislocation of
fragments to the intravascular system is a rare but life-threatening
condition. When a complication occurs, depending on the patient's clinical
condition, the first step is transcutaneous endovascular removal of the
catheter's fragment. If this is not possible, surgical thoracotomy is
necessary. The objective of this article was to present a case of breakage
and dislocation of Hickman catheter in pediatric patient, as well as the
diagnostic and therapeutic approach to complications. Case outline. We
report a 14-month-old child who had a Hickman catheter because he was
undergoing treatment for acute juvenile myelomonocytic leukemia. Due to a
malfunction of the catheter, the existing catheter had to be removed. During
the surgical procedure, a breakage and dislocation of the catheter fragment
occurred. A chest x-ray and an echocardiography confirmed the position of
the catheter fragment in the right atrium. A transcutaneous endovascular
procedure was successfully performed to remove part of the catheter.
Conclusion. Numerous complications can occur during the insertion,
management, and removal of long-term catheters. It is necessary to
periodically control the catheter's position by chest x-ray and ultrasound
of the heart and neck. If a particular complication is detected, an
individual approach to treatment with the lowest risk to the patient should
be chosen. Dislocated fragments of the Hickman catheter can be safely
removed by endovascular transcatheter procedures.