Infusion of TPN into the liver from malpositioned umbilical venous catheters

A case series from a single center describes five neonates who had parenteral nutrition inadvertently infused into the liver from malpositioned umbilical venous catheters. Presenting features were abdominal distension, hemodynamic instability and anemia. Diagnosis was confirmed by ultrasound which showed intrahepatic fluid collections. Therapy consisted of needle aspiration in three cases, abdominal surgery to relieve abdominal compartment syndrome in one case, and conservative management in one case. Follow-up ultrasound revealed intrahepatic calcification in some infants.

 Clinical-radiologic features and treatment of hepatic lesions caused by inadvertent infusion of parenteral nutrition in liver parenchyma due to malposition of umbilical vein catheters. Hagerott et al. 2014