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Superior vena cava thrombosis causing respiratory obstruction successfully resolved by stenting in a small bowel transplant candidate
  1. M Petersa,
  2. S V Beathb,
  3. J W L Puntisc,
  4. P Johna
  1. aDepartment of Radiology, The Birmingham Children's Hospital, bDepartment of Hepatology, cNeonatal Unit, Leeds General Infirmary
  1. Dr P John, Consultant Paediatric Radiologist, Birmingham Children's Hospital NHS Trust, Steelhouse Lane, Birmingham B4 6NH, UK email: philip.john{at}bhamchildrens.wmids.nhs.uk

Abstract

A 4 year old child was referred for small bowel transplantation. He had superior vena cava obstruction secondary to numerous central venous line placements; alternative routes for long term central venous access were compromised by extensive venous occlusive disease. Patency for the superior vena cava was re-established with stenting, which allowed for radiological placement of another central venous line.

 Long term survival in infants and young children with intestinal failure is dependent on adequate central venous access for the administration of parenteral nutrition. Line sepsis and physical damage to the catheter often necessitates multiple central venous catheter placements during their early life and these children are at risk of catheter related veno-occlusive disease. Recurrent sepsis and the loss of satisfactory venous access for the administration of parenteral nutrition is life threatening and is an indication for intestinal transplantation in up to 41% of patients reported by the small bowel registry.

  • bowel transplant
  • vena cava thrombosis

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