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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 right 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.
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.
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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