A CLINICAL CASE OF ARTERIAL THROMBOSIS IN A PREMATURE BOY WITH NEONATAL SEPSIS AND HIGH RECTAL ATRESIA

Abstract

Occlusion of the venous or arterial vessels in childhood is rather rare but dangerous complication. Occurrence of neonatal thrombosis is 0.5 per 10 000 of live newborns. Promoting factors include congenital defects of coagulation, maternal diabetes, neonatal sepsis, necrotic enterocolitis, asphyxia, and metabolic diseases. More than 90 % cases of neonatal thrombosis are associated with catheterization (umbilical arterial or venous, other central venous lines). Acute arterial thrombosis caused by a peripheral venous catheter is very rare complication, but it can result in severe consequences. The article contains a clinical case of right brachial artery thrombosis in a premature boy with extremely low body weight complicated by development of dry gangrene and amputation of the limb. Complex risk factors promoting development of neonatal arterial thrombosis were found: preterm birth, neonatal sepsis, possible incorrect insertion of a peripheral venous catheter. Associative factors were congenital developmental defects of the intestine (high rectal atresia) and heart (bicuspid aortal valve, open oval foramen), and maternal factors. The authors emphasize their attention on the necessity to continuous education of the medical staff concerning the technique of catheter insertion and care of them, absolute implementation of safety policy concerning nosocomial infection, adequate provision of ultrasound examination devices with high rarefaction sensors, involvement of a multi-disciplinary team of specialists to manage complicated clinical cases.