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Arch Dis Child Fetal Neonatal Ed doi:10.1136/archdischild-2012-301895
  • Images in paediatrics

Surgical retrieval of transected umbilical catheter from preterm infant

  1. David Harding1
  1. 1NICU, St Michael's Hospital, Bristol, Bristol, UK
  2. 2Department of Paediatric Surgery, Bristol Royal Hospital for Children, Bristol, UK
  3. 3Department of Paediatrics, Musgrove Park Hospital, Taunton, UK
  4. 4Department of Paediatric Radiology, Bristol Royal Hospital for Children, Bristol, UK
  1. Correspondence to Dr John-Paul Smith, NICU, St Michael's Hospital, Southwell Street, Bristol BS2 8EG, UK; jposmith{at}gmail.com
  • Accepted 15 August 2012
  • Published Online First 22 September 2012

We present a 26 weeks gestation boy with a complication of central venous catheterisation. He was intubated in delivery suite, and admitted for intensive care. An umbilical venous catheter (UVC) was placed and used; however, there was difficulty obtaining umbilical arterial catheterisation (UAC) access due to thin cord. During subsequent attempts to place a UAC, the UVC was transected. It migrated inwards and could not be retrieved. The baby was transferred for on-going care, radiology and surgical management. Radiographs confirmed 6cm of catheter from umbilical vein to left atrium (figures 1 and 2). This did not cause compromise, and peripheral long-line and arterial lines were used in place of umbilical access. Echocardiogram revealed no clot formation in the atrium. The UVC was removed surgically via a supraumbilical incision. Careful isolation of the umbilical vein very close to the liver was necessary to retrieve the migrating catheter. This case highlights an unusual complication of umbilical catheter use and a method of retrieval.

Figure 1

Left lateral chest x-ray.

Figure 2

Anteroposterior chest x-ray.

These images demonstrate the umbilical catheter remnant in the umbilical vein, ductus venosus and right atrium. Echocardiogram was also performed. Permission for publication has been obtained from the patient's parents.

Footnotes

  • Contributors The above authors all contributed to the preparation of this manuscript. J-PS is responsible for the overall content and guarantor. ELC, DH, NJ, SM were involved in clinical care of patient and event described. All the authors contributed to editing and minor amendments to the text.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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