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CT-guided retrieval of a fractured intravenous cannula in a toddler: A case report
Peter Olalekan Adeosun1, Abdulateef Temitope Abdulazeez2, Uchenna Ifeoma Okeke3
1Department of Oral and Maxillofacial Surgery, Nigerian Navy Reference Hospital, Calabar, Cross River State, Nigeria.
Insights
A toddler experienced a fractured peripheral intravenous cannula (PIVC) during insertion. Prompt computed tomography and surgical removal were crucial for managing this rare, potentially fatal complication.
Area of Science:
- Medical Device Safety
- Pediatric Emergency Medicine
- Surgical Complications
Background:
- Fractured peripheral intravenous cannulas (PIVCs) are rare but serious complications during insertion.
- This event can lead to potentially fatal outcomes if not managed promptly.
Observation:
- A 30-month-old boy presented with an iatrogenic PIVC fracture during attempted insertion.
- A 7mm segment of the fractured cannula remained in the toddler's tissues, undetected by palpation.
Findings:
- Computed tomography (CT) successfully located the non-palpable retained cannula fragment.
- Surgical intervention under general anesthesia was required for the removal of the foreign body.
Implications:
- Retained fractured PIVCs pose an emergency risk due to potential embolization.
- Strict adherence to PIVC insertion guidelines and the utility of CT imaging in management are highlighted.
Introduction:
Fractured cannula is a complication of peripheral intravenous cannula (PIVC) insertion. It is a rare but potentially fatal complication. We present a case of iatrogenic fracture of a PIVC in a toddler.
Case Report:
An acutely ill 30-month-old boy presented at the emergency room and a PIVC insertion was attempted several times using the same cannula which fractured in the process. While the main part of the device was recovered, about 7 mm of the cannula was retained in the tissues and was not palpable. Computed tomography was used to locate the foreign body which was surgically removed under general anesthesia.
Discussion:
A fractured and retained PIVC, especially when it is not palpable clinically, is an emergency due to possible embolization and the consequent potentially fatal outcome. This case underscores strict adherence to standard guidelines in prevention and the importance of computed tomography in the management of this condition.
