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.