Retained umbilical artery catheter presenting as an umbilical abscess

A Rare Case of an Intraluminal Abscess of the Umbilical Artery as Differential Diagnosis for Omphalitis in Newborns

“…Manipulation with resulting contamination of the vessels is known to be a risk factor for infections, while this rarely leads to intraluminal abscess formation. Despite this, Kotnis et al reported a case where a remnant of an arterial catheter in the umbilical artery caused recurrent umbilical infections [10]. In our case, there was no insertion of a catheter reported, so these cases are hardly comparable.…”

Retained Catheter in the Aorta

“…This case demonstrates an incidental finding of a retained umbilical artery catheter fragment in an adult patient’s aorta. There are several case reports of retained umbilical artery catheter fragments in neonates and infants, which resulted in thrombosis, infection, and embolization 1,2. This is the first known finding of a retained umbilical artery catheter found in an adult patient.…”

Infraumbilical surgical retrieval of transected umbilical artery catheter in an 840 g newborn

“…The evidence supporting any management option for removal of retained UAC remains weak. There have been less than 15 case reports in the past 50 years outlining the removal of a UAC via either transcutaneous, trans umbilical surgical approach, exploratory laparotomy and/or aortotomy 2–13…”

“…The concern about a conservative approach was surrounding the potential complications that can occur from leaving the fragment in situ, which include its migration, abscess formation, infection, ischaemia and/or thrombosis as described in previous cases prior to removal 2–5 15. Prophylactic heparin dose was considered; however, given the lack of studies in the neonatal population and in particular in preterm newborns, it was not clear what the safest dose would be to balance the risks of bleeding (especially intraventricular haemorrhage) and thrombosis in an extreme preterm baby, who has a different physiological coagulation profile to term babies and older children 16.…”

“…Umbilical arterial catheterisation is a common practice in neonatal intensive care units (NICU) especially in the extreme preterm and very low birth weight infants. As with any procedure, it is associated with complications, including perforation of vessels at the time of insertion, thrombosis, bacterial infection, compromise of flow to distal vascular bed and in rare cases transection/fracture of the UAC itself leading to displacement/migration of the catheter internally 1–4…”