Hepatic Lesions of Total Parenteral Nutrition (Tpn) Secondary to Umbilical Venous Catheter (Uvc) Malposition in A Very Low-Birth Weight Infant in China

Xiao-Ping Luo,Yan-Wei Liu,Li Wang

doi:10.31579/2694-0248/036

Abstract

Umbilical vein catheterization (UVC) is a common operation for vascular access in preterm infants. However, there are complications associated with their use. We here a case of extravasation of the fluids due to misplacement of the catheter causing hepatic collection of TPN in a very low-birth weight preterm (VLBW) infant.

Highlights

Umbilical vein catheterisation (UVC) is a common procedure performed in neonatal intensive care unit (NICU) [1]
We present a case of preterm baby who developed partial necrosis of liver following a malposition UVC with successful recovery following discontinuation of the catheter and abdominal paracentesis of the fluid
Figure 4d: A follow-up US in infant who underwent a US-guided aspiration of hepatic collection 6 months after the procedure shows a resolving lesion with residual dystrophic calcifications. This case showed that the UVC was improperly placed and prolonged parenteral nutrition infusion, which the entry of hypertonic fluid into the liver tissue may lead to parenchymal injury or parenchymal necros

Summary

Introduction

Umbilical vein catheterisation (UVC) is a common procedure performed in neonatal intensive care unit (NICU) [1]. US on day 9 of life demonstrates a large heterogeneous fluid complex collection measuring 5.7×4.0 cm in the liver. In view of the critically ill state of the infant, the surgeons performed an US-guided hepatic collection aspiration by inserting a Penrose drain to relieve the abdominal pressure. The US examination of the abdomen 3 days post-hepatic collection aspiration revealed collection of fluid in the liver. Figure 3b: US showed a solid-cystic echogenic lesion measuring 3.6×2.8cm with internal visible separation after the US-guided drainage. Figure 3c: Repeat US examination showed the lesion do not have been absorbed measuring 3.0×2.3cm with no vascularity. Figure 4d: A follow-up US in infant who underwent a US-guided aspiration of hepatic collection 6 months after the procedure shows a resolving lesion with residual dystrophic calcifications

Discussion

Conclusion