Peripherally inserted central venous catheter fracture and embolization to the lung

Area of Science:

• Pediatric Medicine
• Cardiovascular Surgery
• Pulmonary Medicine

Background:

• Peripherally inserted central venous catheters (PICCs) are increasingly utilized for prolonged venous access in pediatric patients.
• Catheter fracture is a known but infrequent complication associated with these devices.
• Fragment migration poses a significant risk of serious systemic or organ-specific complications.

Observation:

• An adolescent patient presented with a fractured PICC.
• The fractured catheter fragment migrated from the venous system, through the heart.
• The embolized fragment lodged in the lower lobe of the right lung.

Findings:

• Physical examination findings were unremarkable and did not suggest pulmonary embolization.
• Radiographic or imaging studies were crucial in diagnosing the catheter migration.
• The case demonstrates a rare pathway of embolization from a fractured PICC.

Implications:

• Pediatric emergency physicians must maintain a high index of suspicion for catheter fragment embolization, even with subtle clinical signs.
• Awareness of this complication is critical for timely diagnosis and management.
• This case underscores the importance of careful monitoring and appropriate management of patients with indwelling central venous catheters.