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Hydrothorax following delayed extravascular migration of a totally implantable venous access device in a child

  • Chein-Lin Huang
    Affiliations
    Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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  • Pei-Chin Lin
    Affiliations
    Division of Pediatric Hematology/Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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  • Jui-Ying Lee
    Affiliations
    Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • Yu-Tang Chang
    Correspondence
    Corresponding author. Division of Pediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan. Tel.: +886 7 3121101 6206.
    Affiliations
    Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Department of Surgery, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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      Abstract

      Totally implantable venous access devices are widely used in pediatric oncology. The authors encountered a 10-year-old boy with implantation of the device at the age of 7 years owing to acute lymphoblastic leukemia. In the recent half-year, the device was not used except for regular heparin flushing. However, hydrothorax occurred when fluid therapy was required from the device during this admission. Thoracoscopic approach showed extravascular migration and intrapleural malposition of the catheter. Intrapleural migration of the extravascular portion of the catheter owing to irritation and pressure necrosis of the pleura and gradual shortening of intravascular portion of the catheter when the child grew up may be the pathogenesis of delayed extravascular migration of the catheter.

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      References

        • Gebauer B.
        • Teichgräber U.K.
        • Podrabsky P.
        • et al.
        Radiological interventions for correction of central venous port catheter migrations.
        Cardiovasc Intervent Radiol. 2007; 30: 668-674
        • Narducci F.
        • Jean-Laurent M.
        • Boulanger L.
        • et al.
        Totally implantable venous access port systems and risk factors for complications: a one-year prospective study in a cancer centre.
        Eur J Surg Oncol. 2011; 37: 913-918
        • Hackert T.
        • Tjaden C.
        • Kraft A.
        • et al.
        Intrapulmonal dislocation of a totally implantable venous access device.
        World J Surg Oncol. 2005; 3: 19
        • Gonda S.J.
        • Li R.
        Principles of subcutaneous port placement.
        Tech Vasc Interv Radiol. 2011; 14: 198-203
        • Vazquez R.M.
        • Brodski E.G.
        Primary and secondary malposition of silicone central venous catheters.
        Acta Anaesthesiol Scand Suppl. 1985; 81: 22-26
        • Collin G.R.
        • Ahmadinejad A.S.
        • Misse E.
        Spontaneous migration of subcutaneous central venous catheters.
        Am Surg. 1997; 63: 322-326
        • Renaud S.
        • Santelmo N.
        • Falcoz P.E.
        • et al.
        Mediastinal infusion with tracheal necrosis: an unusual complication of Port-a-cath devices.
        Interact Cardio Vasc Thorac Surg. 2011; 12: 1007-1009
        • Laureys M.
        • Rommens J.
        Spontaneous repositioning of a chest port catheter by contrast medium injection.
        Cardiovasc Intervent Radiol. 2007; 30: 543-544
        • Dunbar R.D.
        • Mitchell R.
        • Lavine M.
        Aberrant locations of central venous catheters.
        Lancet. 1981; 28: 711-715
        • Milam M.G.
        • Sahn S.A.
        Horner's syndrome secondary to hydromediastinum. A complication of extravascular migration of a central venous catheter.
        Chest. 1988; 94: 1093-1094
        • Sridhar S.
        • Thomas N.
        • Kumar S.T.
        • et al.
        Neonatal hydrothorax following migration of a central venous catheter.
        Indian J Pediatr. 2005; 72: 795-796
        • Madhavi P.
        • Jameson R.
        • Robinson M.J.
        Unilateral pleural effusion complicating central venous catheterisation.
        Arch Dis Child Fetal Neonatal Ed. 2000; 82: F248-F249
        • Chang Y.T.
        • Dai Z.K.
        • Kao E.L.
        • et al.
        Early video-assisted thoracic surgery for primary spontaneous hemopneumothorax.
        World J Surg. 2007; 31: 19-25
        • Chiang H.H.
        • Lee J.Y.
        • Chou S.H.
        • et al.
        Simultaneous occurrence of ipsilateral primary spontaneous hemopneumothorax and contralateral pneumothorax in an adolescent.
        J Pediatr Surg. 2009; 44: 1821-1823