Retrieval of retained fractured intravenous cannula of external jugular vein: a rare report

Nikitha Chinnamaraju; Samarth Sahoo; Naga Vamsikrishna; Krishna Ramavath; Harikrishna Balchandran

doi:10.18203/2349-2902.isj20251546

Authors

Nikitha Chinnamaraju All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
Samarth Sahoo All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
Naga Vamsikrishna All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
Krishna Ramavath All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
Harikrishna Balchandran All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20251546

Keywords:

Intravenous cannula, External jugular vein, Cannula fracture, Ultrasound, Health care givers

Abstract

Intravenous cannulation is most common invasive procedure often performed by nursing officers and junior colleagues in the emergency department. Peripheral venous route of upper limb is often preferred over neck venous route. Even though it is a simple routine invasive procedure it can lead to extravascular infiltration, double puncture of vessel walls, thrombophlebitis, hematoma, catheter associated blood stream infections, trauma to surrounding structures like tendon, nerve injuries and air embolism. Fracture of neck intra venous (external jugular vein) cannula in situ is rare and it can cause serious complications if it is neglected. It acts as a retained intravascular foreign body with lethal complications. Hence, the quality of manufacturing of cannula and proper training and technique can prevent potential complications associated with peripheral cannulation. We report a rare case of fractured and slightly migrated intravenous cannula of external jugular vein (EJV) during cannula removal and successfully removed from the EJV under local anesthesia.

Metrics

Metrics Loading ...

References

Zingg W, Pittet D. Peripheral venous catheters: an under-evaluated problem. Int J Antimicrob Agents. 2009;34(4):S38-42. DOI: https://doi.org/10.1016/S0924-8579(09)70565-5

Karunathilaka C, Wijesundara V, Madushanka N. Intravenous Fracture of a Peripheral Cannula at the Dorsum of the Hand in a Patient Who Used Walking Aids after Surgery. Open J Orthop. 2021;11:146-52. DOI: https://doi.org/10.4236/ojo.2021.114014

Nyamuryekung'e MK, Mmari EE, Patel MR. A missing piece: Fracture of peripheral intravenous cannula, a case report. Int J Surg Case Rep. 2021;78:296-9. DOI: https://doi.org/10.1016/j.ijscr.2020.12.030

Glassberg E, Lending G, Abbou B, Lipsky AM. Something’s missing: peripheral intravenous catheter fracture. J Am Board Fam Med. 2013;26(6):805-6. DOI: https://doi.org/10.3122/jabfm.2013.06.130097

Chhikara M, Bansal S, Bansal N, Raja RM. A broken intravenous cannula in external jugular vein: A rare catastrophe managed timely. Indian J Anaesth. 2022;66(12):880-1. DOI: https://doi.org/10.4103/ija.ija_558_22

Kocaoğlu AS, Demirdizen G, Taştekin T, Sisli E. Intravenous cannula fracture in external jugular vein access: A case report. Cardiovasc Surg Int. 2022;9(1):56-8. DOI: https://doi.org/10.5606/e-cvsi.2022.1211

Singh A, Kaur A, Singh M, Kaur S. CT Guided Removal of Iatrogenic Foreign Body: A Broken Intravenous Cannula. J Clin Diagn Res. 2015;9(9):PD28-9. DOI: https://doi.org/10.7860/JCDR/2015/14344.6549

Dell’Amore A, Ammari C, Campisi A, D’Andrea R. Peripheral venous catheter fracture with embolism into the pulmonary artery. J Thorac Dis. 2016;8(12):E1581-4. DOI: https://doi.org/10.21037/jtd.2016.12.02

Turner DD, Sommers SC. Accidental passage of a polyethylene-catheter from cubital vein to right atrium; report of a fatal case. N Engl J Med. 1954;251:744-5. DOI: https://doi.org/10.1056/NEJM195410282511806