Selahattin AKAR, Sevilay TOPCUOĞLU, Emre DİNCER, Selim SANCAK, Güner KARATEKİN, Fahri OVALI

Nekrotizan Enterokolit ile Karışabilen Nadir Bir Umblikal Venöz Kateter Komplikasyonu: Total Parenteral Nütrisyonun İntraperitoneal Ekstravazasyonu

Umblikal venöz kateter UVK ilaç tedavisi, tetkik için kan alma, exchange transfüzyon ve total parenteral nütrisyon TPN için özellikle çok düşük doğum ağırlıklı bebeklerde sık uygulanan invazif girişimlerden biridir. TPN’nin intraperitoneal ekstravazasyonu UVK’nın nekrotizan enterokolit ile karışabilen nadir bir komplikasyonudur. Bu yazıda batına TPN ekstravazasyonu saptanan iki olguyu sunduk. Prematürelik nedeniyle yenidoğan yoğun bakım ünitesinde takip edilen iki olgumuzdan birincisinde postnatal 2. günde, ikincisinde postnatal 9. günde batın distansiyonu ve kusma şikayetleri olması üzerine nekrotizan enterokolit ön tanısıyla enteral beslenme kesildi, gastrik serbest drenaja alındı, antibiyotik tedavisi başlandı. Batın ultrasonografisinde serbest sıvı saptanan olguların parasentez sıvısının makroskopik ve mikroskopik değerlendirilmesi TPN ile uyumlu saptandı. Prematüre bebeklerde batın distansiyonu ve assit gelişen olgularda ayırıcı tanıda UVK komplikasyonu olarak total parenteral nütrisyonun intraperitoneal ekstravazasyonu olabileceği ve parasentez sıvısının makroskopik görüntüsünün ve biyokimyasal analizinin yol gösterici olabileceği unutulmamalıdır

Anahtar Kelimeler:

Kateter, ekstravazasyon, total parenteral nütrisyon

A Rare Umbilical Venous Catheter Complication Miscible with Necrotizing Enterocolitis: Intraperitoneal Extravasation of Total Parenteral Nutrition

Umbilical venous catheter UVC is one of the most frequently performed invasive procedure especially to very low birth weight infants for total parenteral nutrition TPN , exchange transfusion and drawing blood samples. Intraperitoneal extravasation of total parenteral nutrition is a rare complication miscible with necrotizing enterocolitis. In this report, we presented two patients with intraperitoneal extravasation of total parenteral nutrition solution. Due to prediagnosis of necrotizing enterocolitis, feeding was withheld with gastric decompression and antibiotic treatment was started in the two preterm babies hospitalized in neonatal intensive care unit, after abdominal distension and vomiting symptoms developed on the postnatal second day for the former patient and on the postnatal ninth day for the latter patient. The cases were diagnosed with ascites by ultrasonographic evaluation of abdomen and the paracentesis material was found to be compatible with TPN solution. In differential diagnosis of preterm babies with ascites and abdominal distension, it must not be forgotten that extravasation of total parenteral nutrition solution may be the complication of UVC and macroscopic appearance and biochemical analysis of paracentesis material may lead to the diagnosis

Keywords:

Catheter, extravasation, total parenteral nutrition,

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