Malpositioned umbilical venous catheter after thoracoscopic repair of diaphragmatic eventration

Abstract

Diaphragmatic hernia and eventration of the diaphragm as congenital defects have similar clinical and radiological presentations. The umbilical venous catheter is successfully used for venous access in a neonatal age group with minimal complications. We present a case of a two-day-old neonate, initially scheduled for thoracoscopic repair of right diaphragmatic hernia. But, the intraoperative evaluation revealed the right diaphragmatic eventration. After initial ventilation and optimization in the neonatal intensive care unit, the baby was taken up for thoracoscopic repair under general anesthesia. The postoperative abdominal radiograph showed migration of umbilical vein catheter into the portal vein cephalad. The possible explanation is liver reposition to standard anatomical localization upon surgical correction. The catheter was uneventfully pulled back to its optimal position.

Keywords

• congenital diaphragmatic hernia
• diaphragmatic eventration
• malpositioned catheter
• umbilical venous catheter