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Case Reports: Unusual presentation of more common disease/injury
Thrombus calcification after removing peripherally inserted central catheters in extremely preterm infants
  1. Takashi Shima1,2,
  2. Takeshi Kusuda1,
  3. Nobuhiko Kan1 and
  4. Tadamune Kinjo1
  1. 1Neonatology, Fukuoka Children's Hospital, Fukuoka, Fukuoka, Japan
  2. 2PGDip in Neonatal Medicine, Cardiff University, Cardiff, UK
  1. Correspondence to Dr Takashi Shima; ShimaT{at}cardiff.ac.uk

Abstract

Pericatheter thrombus calcification is a complication that arises due to central venous catheter insertion and is particularly rare in peripherally inserted central catheters (PICCs). In this case report, we reviewed the clinical course of two neonates experiencing thrombus calcification. The first case involved a male neonate weighing 445 g. His PICC dwelt in the superior vena cava for over 49 days. Although a radiograph after removal did not show any silhouette, subsequent radiographs and CT depicted a catheter-like outline. Percutaneous intravascular retrieval was performed to salvage the object. Pathological examination revealed it to be a calcified cast. The calcified thrombosis was successfully dissolved with 6 months of warfarin therapy. The second case involved a male neonate weighing 534 g. After PICC removal, a catheter-like structure was shown on ultrasonograms. It was determined that invasive procedures were unnecessary for diagnosing the calcified thrombosis based on experience with the first case.

  • Neonatal and paediatric intensive care
  • Pathology
  • Radiology
  • Unwanted effects / adverse reactions
  • Venous thromboembolism

https://doi.org/10.1136/bcr-2022-249174

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    Footnotes

    • Contributors TS, primary physician, was in charge of the patients and wrote the manuscript. T Kusuda, senior neonatologist, worked as a team in diagnosing these cases and critically appraised the literature. NK, senior cardiologist, was involved in managing the case and approved the final manuscript. T Kinjo, senior neonatologist, supervised TS and guided the writing and editing of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.