Total intravenous hyperalimentation (TIH) complications in childhood: a radiological survey

Abstract

Sixty consecutive patients, except for one 7-year-old patient, their ages varying from 1 day to 12 months received total intravenous hyperalimentation (TIH). It was possible to observe non-pathological catheter malpositions and, in 14 patients, other complications. The most serious complications observed included the following: thrombus and pericatheter thrombus calcification; superior vena cava thrombotic occlusion; hydrothorax; mediastinal effusion; generalized septic arthritis; venous transfixion with flooding of the soft tissues of the neck; vein wall lesions; collateral vertebral circulation; and a catheter tip blocked in vein. A brief comment is given on the use of this procedure and what may happen.

Calcified catheter “cast” masquerading as a retained catheter fragment after removal of an implanted venous access device

“…The possibilities of a retained catheter fragment as well as a grossly calcified thrombus were excluded on venogram. A calcium cast of a CVC has been reported twice in the literature [1,2]. These two reports differ from our own since (a) both previously reported cases involved infants who required a CVC for TPN, whereas our case involved an older child whose port was necessary for chemotherapy, and (b) both previously reported cases involved calcified thrombus, whereas our case revealed no grossly calcified thrombus on further testing.…”

“…Four other cases involving calcified thrombus in the right atrium associated with central venous catheterization have been reported [1,[12][13][14]. One involved an adult woman receiving long-term intravenous phosphate therapy [12], and the remaining three involved children receiving TPN [1,13,14].…”

“…One involved an adult woman receiving long-term intravenous phosphate therapy [12], and the remaining three involved children receiving TPN [1,13,14]. One of the aforementioned children had a normal CXR despite presence of a calcified thrombus.…”

“…Calcified catheter ''cast'' is a rare complication of central venous catheterization that has been reported in the literature twice [1,2]. The first case described an infant with a calcified thrombus in the superior vena cava surrounding the tip of a central venous catheter (CVC) that had been used for total parenteral nutrition (TPN) [1].…”

“…The first case described an infant with a calcified thrombus in the superior vena cava surrounding the tip of a central venous catheter (CVC) that had been used for total parenteral nutrition (TPN) [1]. A diagnosis of calcified pericatheter thrombus was made based on chest X-ray (CXR) showing a thin shell surrounding the superior vena cava after catheter removal.…”