Calcified catheter-related fibrin sheath in a child (case report and a brief literature review)
https://doi.org/10.24835/1607-0771-2020-3-65-73
Abstract
A rare case of a calcified fibrin sheath, fixed in the vein lumen, in a 4.5-year-old child with acute lymphoblastic leukemia, which was visualizing for several months after central venous catheter removal, is presented in the article. The fibrin sheath on the catheter was first detect in a patient during the routine brachiocephalic veins ultrasound in the period of a course of specific therapy. A hyperechoic tubular mass with a posterior acoustic shadow in the lumen of internal jugular vein imaged after catheter removal. Position, size, and shape of calcified fibrin sheath was not change during the next 16 months of follow-up. There were no signs of thrombosis, infection or embolism in the child. Fibrin sheaths formation on central venous catheter is the physiological response to the presence of a foreign body. Usually, it is asymptomatic, but it can lead to catheter dysfunction and rare to life-threatening complications after catheter removal: pulmonary embolism, sepsis, and heart walls and valves injury. On various imaging modalities (ultrasound, X-ray, and computed tomography) calcified fibrin sheaths can mimic catheter fragments left in the vein. To avoid misdiagnosis the thorough revision and length measurement of the catheter during its removal, assessment of the catheter contours, and additional masses in its projection on radiological and ultrasound examinations are necessary.
About the Authors
A. B. Sugak
Research Center for Obstetrics, Gynecology, and Perinatology
Russian Federation
Russian Federation
A. A. Amosova
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology
Russian Federation
Russian Federation
M. A. Tarasov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology
Russian Federation
Russian Federation
E. A. Filippova
Research Center for Obstetrics, Gynecology, and Perinatology
Russian Federation
Russian Federation
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For citations:
Sugak A.B., Amosova A.A., Tarasov M.A., Filippova E.A. Calcified catheter-related fibrin sheath in a child (case report and a brief literature review). Ultrasound & Functional Diagnostics. 2020;(3):65-73. (In Russ.) https://doi.org/10.24835/1607-0771-2020-3-65-73
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