Intrahepatic encystment of umbilical vein catheter infusate

Abstract

Massive hepatomegaly in a 2.1 kg female infant, with an indwelling umbilical vein catheter for total parenteral nutrition, occurred on the 10th day of life. Ultrasound and computed tomography studies revealed a large hepatic cyst filled with the catheter infusate. Percutaneous drainage brought about subsequent recovery. To our knowledge, this complication of umbilical vein catheter use has not been previously reported.

Hepatic laceration because of malpositioning of the umbilical vein catheter: case report and literature review

“…Hepatic injures are more severe than the other complications with a high risk for morbidity and mortality (Table 1) [7][8][9][10][11][12][13][14]. Lim-Dunham [9] and associates studied the characteristic sonographic findings of hepatic erosion by UVCs.…”

“…In addition, hypertonic parenteral solutions and catheter malposition have been incriminated in the development of liver necrosis and a resultant abscess [8]. The hypertonicity or elevated pH of materials infused through the catheter may produce local injury turning into necrosis and hepatic laceration [13]. Hepatic injury may be a possible complication of dopamine infusion through an inappropriately placed UVC [18].…”

“…Although a wide experience has been gained since its use was first described in 1947 [3], several mild to serious complications related to the UVC have been reported in the English literature [1,[4][5][6]. Complications related to the liver have a high rate of morbidity and mortality, particularly in small premature newborns [7][8][9][10][11][12][13][14]. To the best of our knowledge, less than 4 articles describing hepatic laceration because of direct injury of the UVC have been reported by now [7][8][9][10][11].…”

Characteristic Sonographic Findings of Hepatic Erosion by Umbilical Vein Catheters

“…The literature shows only 11 cases of hepatic erosion by UVCs in which the patient had abdominal radiographs. [2][3][4] All neonates had abdominal distension, and in all of them, the abdominal radiographs showed malposition of the UVC with the tip below the diaphragm overlying the liver. In 6 of these 11 neonates, the diagnosis of hepatic erosion was made by visualizing liver parenchymal staining and peritoneal extravasation of contrast material injected through the UVC.…”

Neonatal portal vein thrombosis successfully treated by regional streptokinase infusion

“…Following reports of these complications, the use of UVC has decreased considerably but it is still the usual route for exchange transfusion, for emergency venous access and for venous access when peripheral access is difficult. Various grades of hepatic pathology in the acute stage and portal hypertension as chronic sequelae have been described with portal vein thrombosis (PVT) [7,12,17]. We report a case of PVT in a neonate following the use of an indwelling portal vein catheter and its resolution following regional administration of streptokinase.…”