RESUMEN
Placement of suprapubic catheters (SPCs) has a relatively low complication rate and is well tolerated by most patients. Most complications take place during initial catheter placement or during replacement. Malposition of the catheter may cause serious damage to the bowel, bladder, or urethra. Care must be taken to ensure proper placement and functionality by the provider. We describe the case of a 66-year-old male with a history of neurogenic bladder and indwelling SPC presenting to the emergency department 36 hours after catheter replacement with bright red blood from the penile urethra, abdominal pain, fever, and hypotension. Computed tomography scan revealed that during replacement the SPC had passed into the penile urethra, with the bulb fully inflated causing rupture of the urethra with resultant sepsis. This case illustrates the importance of confirming SPC placement prior to bulb inflation and patient discharge.
RESUMEN
We report a case of peripherally inserted central catheter (PICC) migration and perforation of the left internal jugular vein in a home health setting in an 80-year-old female. A left sided PICC was placed for treatment of diverticulitis following hospital discharge. She complained of sudden onset left sided neck pain immediately after starting an infusion of vancomycin. In the emergency department the injury was identified by portable chest radiograph and computed tomography of her neck. Following removal of the line, she had an uneventful course. Emergency physicians should be aware of this possible PICC line complication.