Umbilical venous catheterization gone wrong: Hepatic complications

Abstract

Hepatic complications of malposition of umbilical venous catheter (UVC) are uncommon and occur due to extravasation of hypertonic fluids and the blood products in the liver tissue. Various hepatic complications include thrombosis of hepatic vessels, hepatic necrosis, hepatic fluid collections, and hematoma, with the intraparenchymal liver lesions seen along the course of ductus venosus. Radiologists must be aware of these complications and their imaging findings, as the timely recognition and immediate management can prevent the fatal outcome. Here, we present a rare case of intraparenchymal liver lesions associated with malposition of UVC in a preterm baby.

A Preterm Infant With Mild Abdominal Distension and Rising C-Reactive Protein

“…Although UVC was correctly inserted on admission and position was verified by radiology, yet significant TPN extravasation in hepatic parenchyma occurred on day 4. The onset of diagnosis in our patient was earlier than many reported cases of UVC extravasation that manifested usually beyond the first week of life [2][3][4][5]. The prompt diagnosis was augmented by the bed side ultrasonography as a simple noninvasive diagnostic tool that can be operated easily in NICU.…”

Hepatic extravasation complicated by umbilical venous catheterization in neonates: A 5-year, single-center experience

“…This type of hepatic lesion may contribute to insidious infusion with less hypertonic fluid due to the short indwelling duration (mean, 5.5 days), but still results in chemical irritation or injury to the liver. 23 Most (24/33, 72.7%) lesions were located in the left lobe, possibly because UV catheter placement involves the medial part of the left portal vein and the junction of the IVC and right atrium. The regression duration of HE and vascular thrombus is rarely discussed.…”

An approach to the transected umbilical vein catheter: a case series

“…2 Reported complications associated with the insertion of umbilical vein catheters vary from infection, portal vein thrombosis, parenteral nutrition extravasation, catheter embolization, hepatic haematoma, hepatic abscess and can be fatal. 3 When these UVCs fracture, timeous identification and management is focused to prevent major morbidity or even mortality.…”