A Case of Mediastinitis Caused by a Central Venous Port Catheter

Abstract

A 66-year-old male patient with Ra rectal cancer (T4aN2M1c2, Stage IVc) underwent laparoscopic high anterior resection. For the purpose of conducting adjuvant chemotherapy, a totally implantable central venous access port (CV port) was created. After 3 courses of FOLFOX+Pmab therapy, he presented to our hospital with fever and bilateral shoulder pain. A CT scan of the chest showed increased lipid concentrations around the mediastinum, and the tip of the catheter, which had been placed in the superior vena cava when the CV port was created, had dropped into the left brachiocephalic vein. We diagnosed the case as mediastinitis caused by the CV port catheter. His symptoms improved by removal of the catheter and conservative treatment. Although pneumothorax and catheter infection are well-known complications of CV port creation, mediastinitis caused by catheters has rarely been reported. In this study, we report a rare case of mediastinitis caused by a CV-port catheter.