Algorithm for management of stuck ports in pediatric patients: A case report

• Published in: Journal of pediatric surgery case reports Vol. 102; p. 102783
• Main Authors: Bergus, Katherine C., Klingele, Andrew, Srinivas, Shruthi, Minneci, Peter C.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-03-2024; Elsevier
• Subjects: Case report; Central venous catheter; Pediatric; Retained fragment; Central venous catheter; Case report; Retained fragment; Pediatric
• ISSN: 2213-5766; 2213-5766
• DOI: 10.1016/j.epsc.2024.102783

Difficulty removing central venous ports in children is generally uncommon. We present a rare case of intraoperative difficulty with port removal that resulted in catheter breakage.
An 18-year-old girl presented for port removal nearly six years after placement. The catheter was stuck intraoperatively and despite increased tension, proximal dissection, and extraction attempts with a wire, a portion of the catheter broke off intravascularly. Since intraoperative fluoroscopy confirmed that neither end of the catheter had free intravascular motion, the catheter was left in place. The patient has had no apparent complications from this retained portion of the catheter.
It is uncommon to have great difficulty removing a port in a child but in cases where the catheter is stuck, multiple techniques can be attempted intraoperatively to improve chances of removal. If the catheter breaks intraoperatively but has no free intravascular motion on fluoroscopy, it may be reasonable to leave the retained fragment in place and obtain interval imaging to ensure the fragment has not moved.