Contrast echocardiography test for intrapleural extravasation by central venous catheter

Imaging Med. (2014) 6(1), 21–24 ISSN 1755-5191 Pleural effusion resulting in respiratory distress is a rare complication associated with central venous catheters (CVCs) in children with cancer. Early diagnosis is required to avoid life-threatening complications. Herein, we report the diagnosis by safe echocardiography test in a child with nephroblastoma who experienced acute respiratory distress after drug infusion by CVC. The suspicion of catheter displacement was not confirmed by usual first step examination: chest x-ray showed the tip of the catheter projected in site; moreover, the catheter was perfectly functional to aspiration and injection. A contrast echocardiography test with agitated saline demonstrated microbubbles in the pleural effusion and allowed the diagnosis of intrapleural extravasation, probably caused by primary perforation and malposition of the catheter tip.