Abstract
A 56-year-old woman complaining of abdominal pain was diagnosed as having intestinal obstruction and was inserted a long ileus tube at another hospital. On the 8th hospital day, a central venous catheter was inserted via the right femoral vein for infusion when no abnormalities were noted. On the 11th hospital day after she was transferred to our hospital, she developed vomiting and abdominal distention in the early morning and progress of dehydration was noted. Abdominal CT scan showed retroperitoneal fluid retention and ascites, malposition of the tip of the catheter, and a small air image in the vicinity of the tip. Another abdominal CT scan performed after a contrast medium was infused through the catheter revealed leakage of the medium into the retroperitoneum. Ascites retention associated with retroperitoneal infusion due to venous perforation was thus diagnosed. Aberration of the central venous catheter into the lumber vein might be the most likely cause for the venous perforation.
This is the 14th case report on extravasation of infusion fluid which was apparently caused by mislodging of the catheter. Complications caused by the central venous catheter occur in an early time after catheterization in comparatively many cases. However, there are some cases of delayed occurrence of the complication like in this case in which it appeared 20 days after its placement. We must pay attention to this delayed complication after the central venous catheterization.
