Neonatal Compartment Syndrome Secondary to a Failed Peripheral Inserted Central Catheter Insertion: A Case Report

Abstract

Introduction: Neonatal compartment syndrome is a rare phenomenon with a limited number of cases reported in the literature with varying etiologies. Current literature categorizes etiologies as either intrinsic or extrinsic. To the best of our knowledge, difficult delivery and delivery through vacuum are the only two iatrogenic etiologies that have been reported in the literature. Thus, this may be the first reported case of neonatal compartment syndrome secondary to a failed peripherally inserted central catheter (PICC) insertion.

Case report: We present a case of a pre-mature neonate with diffuse discoloration, paralysis, and loss of palpable pulses of the right upper extremity after a failed PICC insertion. The clinical features led to a diagnosis of compartment syndrome. Interventions were not carried out due to the pre-maturity and instability of the patient. The patient passed away at 38 days of age due to refractory hypotension and patent ductus arteriosus.

Conclusion: We present a case of neonatal compartment syndrome caused by a previously unreported etiology, highlighting the current dearth of knowledge. Clinicians should be aware of the unique clinical presentation of neonatal compartment syndrome and maintain high suspicion even without an obvious etiology.

Keywords: Compartment syndrome; neonates; vascular.

Figure 1

(a) Image of the volar aspect of the right hand on initial presentation. (b) Image of the volar aspect of the right hand on initial presentation.

Figure 2

(a) Image of the dorsal aspect of the right upper extremity on initial presentation. (b) Image of the dorsal aspect of the right upper extremity on initial presentation.

Figure 3

(a) Radiograph of the right upper extremity on initial presentation. (b) Radiograph of the right upper extremity on initial presentation.