Nekrotizan Enterokolit ile Karışabilen Nadir Bir Umblikal Venöz Kateter Komplikasyonu: Total Parenteral Nütrisyonun İntraperitoneal Ekstravazasyonu
Abstract
Umblikal venöz kateter UVK ilaç tedavisi, tetkik için kan alma, exchange transfüzyon ve total parenteral nütrisyon TPN için özellikle çok düşük doğum ağırlıklı bebeklerde sık uygulanan invazif girişimlerden biridir. TPN’nin intraperitoneal ekstravazasyonu UVK’nın nekrotizan enterokolit ile karışabilen nadir bir komplikasyonudur. Bu yazıda batına TPN ekstravazasyonu saptanan iki olguyu sunduk. Prematürelik nedeniyle yenidoğan yoğun bakım ünitesinde takip edilen iki olgumuzdan birincisinde postnatal 2. günde, ikincisinde postnatal 9. günde batın distansiyonu ve kusma şikayetleri olması üzerine nekrotizan enterokolit ön tanısıyla enteral beslenme kesildi, gastrik serbest drenaja alındı, antibiyotik tedavisi başlandı. Batın ultrasonografisinde serbest sıvı saptanan olguların parasentez sıvısının makroskopik ve mikroskopik değerlendirilmesi TPN ile uyumlu saptandı. Prematüre bebeklerde batın distansiyonu ve assit gelişen olgularda ayırıcı tanıda UVK komplikasyonu olarak total parenteral nütrisyonun intraperitoneal ekstravazasyonu olabileceği ve parasentez sıvısının makroskopik görüntüsünün ve biyokimyasal analizinin yol gösterici olabileceği unutulmamalıdır
References
- 1. Rejjal AR, Galal MO, Nazer HM, Karim AA, Osba YA. Complications of parenteral nutrition via an umbilical vein catheter. Eur J Pediatr 1993;152:624.
- 2. Hagerott HE, Kulkarni S, Restrepo R, Reeves-Garcia J. Clinicalradiologic features and treatment of hepatic lesions caused by inadvertent infusion of parenteral nutrition in liver parenchyma due to malposition of umbilical vein catheters. Pediatr Radiol 2014;44:810-5.
- 3. Ramasethu J. Complications of vaskuler catheters in the neonatal intensive care unit. Clin Perinatol 2008;35:199-222.
- 4. Hermansen MC, Hermansen MG. Intravaskuler catheter complications in the neonatal intensive care unit. Clin Perinatol 2005;32:141-56.
- 5. Greenberg M, Movahed H, Peterson B, Bejar R. Placement of umbilical venous catheters with use of bedside real-time ultrasonography. J Pediatr 1995;126:633-5.
- 6. George L, Waldman JD, Cohen ML, Segall ML, Kirkpatrick SE, Turner SW, et al. Umbilical vascular catheters: localization by two-dimensional echocardio/aortography. Pediatr Cardiol 1982;2:237-43.
- 7. Raval NC, Gonzalez E, Bhat AM, Pearlman SA, Stefano JL. Umbilical venous catheters: evaluation of radiographs to determine position and associated complications of malpositioned umbilical venous catheters. Am J Perinatol 1995;12:201-4.
- 8. Kanto WP Jr, Parrish RA Jr. Perforation of the peritoneum and intra-abdominal hemorrhage: a complication of umbilical vein catheterizations. Am J Dis Child 1977;131:1102-3.
- 9. Fuchs EM, Sweeney AG, Schmidt JW. Umbilical venous catheterinduced hepatic hematoma in neonates. J Neonatal Perinatal Med 2014;7:137-42.
- 10. Bayhan C, Takcı Ş, Ciftçi TT, Yurdakök M. Sterile hepatic abscess due to umbilical venous catheterization.Turk J Pediatr 2012;54:671-3.
- 11. Yiğiter M, Arda IS, Hiçsönmez A. Hepatic laceration because of malpositioning of the umbilical vein catheter: case report and literature review. J Pediatr Surg 2008;43:39-41.
- 12. Coley BD, Seguin J, Cordero L, Hogan MJ, Rosenberg E, Reber K. Neonatal total parenteral nutrition ascites from liver erosion by umbilical vein catheters. Pediatr Radiol 1998;28:923-7.
- 13. Panetta J, Morley C, Betheras R. Ascites in a premature baby due to parenteral nutrition from an umbilical venous catheter. J Paediatr Child Health 2000;36:197-8.
- 14. Mohan MS, Patole SK. Neonatal ascites and hyponatraemia following umbilical venous catheterization. J Paediatr Child Health 2002;38:612-14.
A Rare Umbilical Venous Catheter Complication Miscible with Necrotizing Enterocolitis: Intraperitoneal Extravasation of Total Parenteral Nutrition
Abstract
Umbilical venous catheter UVC is one of the most frequently performed invasive procedure especially to very low birth weight infants for total parenteral nutrition TPN , exchange transfusion and drawing blood samples. Intraperitoneal extravasation of total parenteral nutrition is a rare complication miscible with necrotizing enterocolitis. In this report, we presented two patients with intraperitoneal extravasation of total parenteral nutrition solution. Due to prediagnosis of necrotizing enterocolitis, feeding was withheld with gastric decompression and antibiotic treatment was started in the two preterm babies hospitalized in neonatal intensive care unit, after abdominal distension and vomiting symptoms developed on the postnatal second day for the former patient and on the postnatal ninth day for the latter patient. The cases were diagnosed with ascites by ultrasonographic evaluation of abdomen and the paracentesis material was found to be compatible with TPN solution. In differential diagnosis of preterm babies with ascites and abdominal distension, it must not be forgotten that extravasation of total parenteral nutrition solution may be the complication of UVC and macroscopic appearance and biochemical analysis of paracentesis material may lead to the diagnosis
References
- 1. Rejjal AR, Galal MO, Nazer HM, Karim AA, Osba YA. Complications of parenteral nutrition via an umbilical vein catheter. Eur J Pediatr 1993;152:624.
- 2. Hagerott HE, Kulkarni S, Restrepo R, Reeves-Garcia J. Clinicalradiologic features and treatment of hepatic lesions caused by inadvertent infusion of parenteral nutrition in liver parenchyma due to malposition of umbilical vein catheters. Pediatr Radiol 2014;44:810-5.
- 3. Ramasethu J. Complications of vaskuler catheters in the neonatal intensive care unit. Clin Perinatol 2008;35:199-222.
- 4. Hermansen MC, Hermansen MG. Intravaskuler catheter complications in the neonatal intensive care unit. Clin Perinatol 2005;32:141-56.
- 5. Greenberg M, Movahed H, Peterson B, Bejar R. Placement of umbilical venous catheters with use of bedside real-time ultrasonography. J Pediatr 1995;126:633-5.
- 6. George L, Waldman JD, Cohen ML, Segall ML, Kirkpatrick SE, Turner SW, et al. Umbilical vascular catheters: localization by two-dimensional echocardio/aortography. Pediatr Cardiol 1982;2:237-43.
- 7. Raval NC, Gonzalez E, Bhat AM, Pearlman SA, Stefano JL. Umbilical venous catheters: evaluation of radiographs to determine position and associated complications of malpositioned umbilical venous catheters. Am J Perinatol 1995;12:201-4.
- 8. Kanto WP Jr, Parrish RA Jr. Perforation of the peritoneum and intra-abdominal hemorrhage: a complication of umbilical vein catheterizations. Am J Dis Child 1977;131:1102-3.
- 9. Fuchs EM, Sweeney AG, Schmidt JW. Umbilical venous catheterinduced hepatic hematoma in neonates. J Neonatal Perinatal Med 2014;7:137-42.
- 10. Bayhan C, Takcı Ş, Ciftçi TT, Yurdakök M. Sterile hepatic abscess due to umbilical venous catheterization.Turk J Pediatr 2012;54:671-3.
- 11. Yiğiter M, Arda IS, Hiçsönmez A. Hepatic laceration because of malpositioning of the umbilical vein catheter: case report and literature review. J Pediatr Surg 2008;43:39-41.
- 12. Coley BD, Seguin J, Cordero L, Hogan MJ, Rosenberg E, Reber K. Neonatal total parenteral nutrition ascites from liver erosion by umbilical vein catheters. Pediatr Radiol 1998;28:923-7.
- 13. Panetta J, Morley C, Betheras R. Ascites in a premature baby due to parenteral nutrition from an umbilical venous catheter. J Paediatr Child Health 2000;36:197-8.
- 14. Mohan MS, Patole SK. Neonatal ascites and hyponatraemia following umbilical venous catheterization. J Paediatr Child Health 2002;38:612-14.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2015 |
| Published in Issue | Year 2015 Volume: 13 Issue: 1 |