SPONTANEOUS PARTIAL FRACTURE OF THE CATHETER OF A TOTALLY IMPLANTABLE SUBCUTANEOUS INFUSION PORT

A totally implantable subcutaneous infusion port was inserted via the left subclavian vein with peel-away sheath in a 45-year-old male patient receiving home parenteral nutrition. Sixteen months after implantation, the patient noted pain in his left clavicular region during home infusion. This was found to be due to the leakage of infusion fluid resulting from partial fracture of the catheter at the level where the catheter passed between the clavicle and first rib. Because the fracture was partial, the catheter did not embolize to the heart or large vessels. Although subcutaneous infusion ports afford patients greater freedom and the ability to lead a more active life than do external catheters, it is emphasized that there may be the risk of spontaneous catheter fracture in patients using subcutaneous infusion ports.