Central Venous Vascular Erosion Complicating Extravasation of Total Parenteral Nutrition

Central venous catheterization Peripherally inserted central catheter Total parenteral nutritionCentral venous catheter (CVC) is commonly used and is a relatively safe procedure for patients who require intravascular volume replacement, pressure monitoring and infusion of various medications including total parenteral nutrition (TPN).Immediate complications include vascular injury, arterial puncture, bleeding, iatrogenic pneumothorax and catheter malposition.Delayed complications include catheter dislodgement, thrombosis and catheter related blood stream infection.Vascular erosion by CVC and subsequent extravasation resulting in hydrothorax, hydromediastinum is one of the delayed complication of CVC insertion.TPN is established nutritional support method for patients who cannot tolerate enteral nutrition in various disease state.Due to its' hypertonicity, central venous access is mandatory for TPN infusion.Extravasation of TPN via CVC is rare, but may carry significant morbidity and mortality.In this brief review, we will discuss incidence, mechanism of vascular erosion, clinical manifestations, and management of this rare complication of central venous extravasation of TPN.