The complication of deep vein thrombosis — a case report of an adolescent with catheter-related thrombosis due to treatment of congestion of caustic substance at the age of 2, treated with stent implantation after 14 years
Abstract
Introduction: Deep vein thrombosis (DVT) is a type of venous thromboembolism, which is a global problem that affects not only adults but also children. Many risk factors are known; inherited or acquired ones caused by sepsis, malignancy, total parenteral nutrition, smoking, medications, or central venous line. Case presentation: The case report presents a complicated medical history of a patient with long-term secondary DVT, finally treated with stent implantation at the age of 16. At the age of 2, he congested a caustic substance, and the treatment resulted in catheter-related thrombosis. Primarily, pharmacological treatment was ineffective. Only after 14 years, subsequently, many treatment attempts, balloon angioplasty, and stent implantation in the left external iliac vein and left common iliac vein were performed successfully via puncture of the right common jugular vein and common femoral veins. The patient was asymptomatic and regularly attended follow-up visits and also control computed tomography venography was performed two times.
Conclusions: This case report shows the successful management of DVT in a pediatric patient. In addition, the importance of a holistic approach and observation due to still unknown long-term complications should be emphasized.
Keywords: secondary deep vein thrombosisvenous interventionstentadolescentexternal iliac vein
References
- Monagle P, Newall F. Management of thrombosis in children and neonates: practical use of anticoagulants in children. Hematology Am Soc Hematol Educ Program. 2018; 2018(1): 399–404.
- Raffini L, Huang YS, Witmer C, et al. Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007. Pediatrics. 2009; 124(4): 1001–1008.
- Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020; 4(19): 4693–4738.
- Dhir A, DeMarsh S, Ramgopal A, et al. Central Venous Line Associated Deep Vein Thrombosis in Hospitalized Children. J Pediatr Hematol Oncol. 2019; 41(7): e432–e437.
- Abood KK, Paul MR, Kuo DJ. Deep Vein Thrombosis in a Young, Healthy Baseball Catcher: A Case Report and Review of the Literature. J Pediatr Hematol Oncol. 2019; 41(4): 321–323.
- Uygun I, Bayram S. Corrosive ingestion managements in children. Esophagus. 2020; 17(4): 365–375.
- Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol. 2013; 19(25): 3918–3930.
- Chirica M, Bonavina L, Kelly MD, et al. Caustic ingestion. Lancet. 2017; 389(10083): 2041–2052.