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Percutaneous central line extravasation masquerading as an abscess.

Binu Govind1, Prakash Ignace Tete, Niranjan Thomas

  • 1Department of Neonatology, Christian Medical College, Vellore , Tamil Nadu, India. Correspondence to: Dr Niranjan Thomas, Professor, Department of Neonatology, Christian Medical College Hospital, Vellore 632 004, Tamilnadu, India. niranjan@cmcvellore.ac.in.

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Summary

A preterm infant developed a complication after central line insertion, diagnosed as lipid extravasation. Proper catheter placement and confirmation are crucial in neonatal intensive care units.

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Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery

Background:

  • Percutaneous central line insertion is a frequent procedure in neonatal intensive care units.
  • Central venous catheters are essential for neonatal care.

Observation:

  • A preterm infant experienced an erythematous swelling post-central line placement.
  • Initial diagnosis suggested an abscess, but further examination revealed lipid extravasation.

Findings:

  • Incision and drainage yielded white fluid with high triglyceride levels, confirming lipid extravasation.
  • The lesion resolved completely after catheter removal.

Implications:

  • This case underscores the necessity of precise central line placement in neonates.
  • Accurate confirmation of catheter position is vital to prevent complications like lipid extravasation.