Lactescent urine following pediatric cardiac surgery due to catheter migration

Central venous catheterization is crucial for the perioperative and postoperative management of neonatal cardiac surgery patients. The procedure can be challenging due to the small size of the vessels, and it carries a high risk of morbidity and mortality. The most common sites for catheter insertion are the jugular or femoral veins; however, jugular access is typically avoided in patients with univentricular heart disease. The most frequent complications associated with central venous catheters are thromboembolic events and infections. Here, we present a case of lactescent urine in the postoperative period following cardiac surgery, attributed to the migration of a central venous catheter into the renal vein.

We report the case of a newborn with an antenatal diagnosis of type B aortic arch interruption, who underwent complete surgical correction on day 9 of life. The infant presented with lactescent urine on postoperative day 5. Extensive investigations revealed that the central venous catheter had migrated into the right renal vein.

Lactescent urine is an uncommon presentation in children and is most often associated with parasitic infections. In our case, this condition was related to the diffusion of parenteral nutrition into the renal vein. This case illustrates a rare postoperative complication, where a central venous catheter migrated into the renal vein following cardiac surgery.