Splenic Abscess: A Rare Complication of the UVC in Newborn

Splenic abscess is one of the rarest complications of the UVC in a newborn and it is hypothesized that it could be due to an infection or trauma caused by a catheter. The case that is being reported presented with abdominal distension and recurrent desaturation with suspicion of neonatal sepsis versus necrotizing enterocolitis. However, the final diagnosis was splenic abscess as a complication of an inappropriate UVC insertion which was discovered by abdominal ultrasound. The patient was given broad spectrum antibiotics empirically and the symptoms were resolved without any surgical intervention. Such cases and controlled studies need to be reported in order to identify further causes and risk factors associated with splenic abscess in a patient with UVC which can eventually help us adopt preventive strategies to avoid such complications. 1. Introduction Common complications of UVCs in a newborn are infection, hemorrhage, vessel perforation, creation of a false luminal tract [1], hepatic abscess or necrosis [2], air embolism, catheter tip embolism, portal venous thrombosis [3], dysrhythmia, and pericardial tamponade or perforation. Splenic abscess can occur in a newborn without any significant symptom and can resolve without any significant intervention but it could per se be the fatal and lethal complication in patients with UVC. Splenic abscess usually is caused by hematogenous embolization and contagious spread. As saving the central lines in newborn is the most common and integral part of any NICU for treatments and nutrition, but care should be taken to avoid the morbidity and mortality related to UVC. 2. Case Report A Sudanese female neonate born at 25 weeks of gestation with birth weight of 980 grams whose mother was known to have autoimmune hepatitis and primary biliary cirrhosis. The patient developed respiratory distress at birth which needed endotracheal intubation connected to mechanical ventilator after giving surfactant followed by UVC and UAC insertion. She was started on Ampicillin and Amikacin after sepsis screen. Moreover, caffeine citrate and total parental nutrition were started from the first day of life. Initial chest X-ray showed ETT in situ, bilateral hazy lung field but normal abdominal gas pattern. Next day, she developed jaundice without any set up which resolved with phototherapy in 2 days. Cranial ultrasound was reported as normal while insignificant PDA was reported by echocardiography. Abdominal X-ray to localize the position of the UVC showed it to be directed to the left side in splenic vein which was corrected