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Bilateral total parenteral nutrition pleural effusions in a 5-week-old male infant

Christopher Flannigan1, Thomas Bourke, Karen Keown

  • 1Paediatric Intensive Care Unit, Royal Belfast Hospital for Sick Children, Belfast, UK. cflannigan@doctors.org.uk

BMJ Case Reports
|July 5, 2012
PubMed

Insights

A neonatal inguinal hernia caused a small bowel obstruction in an infant. Post-surgery, a misplaced central venous catheter led to pleural effusions resembling total parenteral nutrition.

Area of Science:

  • Pediatric Surgery
  • Vascular Complications
  • Neonatal Intensive Care

Background:

  • Small bowel obstruction in neonates often requires surgical intervention.
  • Inguinal hernias are a common cause of neonatal bowel obstruction.
  • Central venous catheters are essential for neonatal intensive care but carry risks.

Observation:

  • A 5-week-old infant presented with small bowel obstruction due to an inguinal hernia.
  • Postoperatively, the infant developed bilateral pleural effusions.
  • The pleural effusions were suspected to be caused by catheter migration.

Findings:

  • The left internal jugular central venous catheter migrated into the inferior thyroid artery and mediastinum.
  • Pleural effusions were biochemically and visually similar to total parenteral nutrition (TPN).
  • Drainage of the pleural effusions led to an uneventful recovery.

Implications:

  • Highlights the rare but serious complication of central venous catheter migration in neonates.
  • Emphasizes the importance of vigilant monitoring for catheter-related complications.
  • Suggests the need for prompt diagnosis and management of iatrogenic pleural effusions in infants.

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