Central venous catheter fracture leading to TPN extravasation and abdominal compartment syndrome diagnosed with bedside contrast-enhanced ultrasound.
Central venous lines may require contrast injection under fluoroscopy to evaluate for dysfunction such as occlusion, fibrin sheath development or catheter fracture. Rarely, some patients may be too ill to travel to the interventional radiology suite for this examination. We present a case utilizing contrast-enhanced ultrasound (CEUS) at the bedside to assess catheter integrity in a critically ill infant with a large intra-abdominal fluid collection. CEUS demonstrated extravasation into the collection, confirming catheter fracture and prompting immediate cessation of line use and recommendation for exchange. This case shows the utility of CEUS to evaluate central venous access devices in children who are unable to travel to interventional radiology for a standard contrast injection.
['Cahill|Anne Marie|AM|', 'Escobar|Fernando|F|', 'Acord|Michael R|MR|0000-0001-8575-0983']
D002405:Catheterization, Central Venous D002406:Catheterization, Peripheral D062905:Central Venous Catheters D002648:Child D006801:Humans D007223:Infant D059325:Intra-Abdominal Hypertension D014463:Ultrasonography
Catheter Extravasation Bedside Contrast-enhanced ultrasound Infant Central venous access Children Total parenteral nutrition