CC BY 4.0 · European J Pediatr Surg Rep. 2017; 05(01): e12-e16
DOI: 10.1055/s-0037-1599795
Case Report
Georg Thieme Verlag KG Stuttgart • New York

Fatal Complications after Pediatric Surgical Interventions: Lessons Learned

Willemijn M. Klein
1   Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
Mayke E. Van der Putten
2   Department of Neonatology, Radboud University Medical Center, Nijmegen, The Netherlands
Benno Kusters
3   Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
Bas H. Verhoeven
4   Department of Pediatric Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
› Author Affiliations
Further Information

Publication History

20 May 2016

26 January 2017

Publication Date:
22 March 2017 (online)


Placement of catheters, drains, shunts, and tubes in children can lead to serious or even fatal complications at the moment of placement, such as hemorrhage at insertion, or in the longterm, such as infections and migration into adjacent organs. The clinician should always be aware of these potential complications, especially if the child is unwell. For postmortem diagnostic evaluation, either with a computed tomography scan or an invasive autopsy, all tubes, drains, shunts, and/or catheters should be left in situ. We present three cases with fatal complications after the placement of a chest drain, ventriculoperitoneal shunt, and gastrostomy tube.

  • References

  • 1 McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med 2003; 348 (12) 1123-1133
  • 2 Eisen LA, Narasimhan M, Berger JS, Mayo PH, Rosen MJ, Schneider RF. Mechanical complications of central venous catheters. J Intensive Care Med 2006; 21 (01) 40-46
  • 3 Bradford NK, Edwards RM, Chan RJ. Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: a systematic review. Int J Nurs Stud 2016; 59: 51-59
  • 4 Kong VY, Oosthuizen GV, Sartorius B, Keene C, Clarke DL. An audit of the complications of intercostal chest drain insertion in a high volume trauma service in South Africa. Ann R Coll Surg Engl 2014; 96 (08) 609-613
  • 5 Kumar SP, Belik J. Chylothorax--a complication of chest tube placement in a neonate. Crit Care Med 1984; 12 (04) 411-412
  • 6 Brooker RW, Booth GR, DeMello DE, Keenan WJ. Unsuspected transection of lung by pigtail catheter in a premature infant. J Perinatol 2007; 27 (03) 190-192
  • 7 Goldin AB, Heiss KF, Hall M. , et al. Emergency department visits and readmissions among children after gastrostomy tube placement. J Pediatr 2016; 174: 139-145.e2
  • 8 Liu R, Jiwane A, Varjavandi A. , et al. Comparison of percutaneous endoscopic, laparoscopic and open gastrostomy insertion in children. Pediatr Surg Int 2013; 29 (06) 613-621
  • 9 Baker L, Beres AL, Baird R. A systematic review and meta-analysis of gastrostomy insertion techniques in children. J Pediatr Surg 2015; 50 (05) 718-725
  • 10 Dookhoo L, Mahant S, Parra DA, John PR, Amaral JG, Connolly BL. Peritonitis following percutaneous gastrostomy tube insertions in children. Pediatr Radiol 2016; 46 (10) 1444-1450
  • 11 Zhao R, Shi W, Yu J, Gao X, Li H. Complete intestinal obstruction and necrosis as a complication of a ventriculoperitoneal shunt in children: a report of 2 cases and systematic literature review. Medicine (Baltimore) 2015; 94 (34) e1375
  • 12 Wei YH, Lee CH, Cheng HN, Tsao LT, Hsiao CC. Pigtail catheters versus traditional chest tubes for pneumothoraces in premature infants treated in a neonatal intensive care unit. Pediatr Neonatol 2014; 55 (05) 376-380
  • 13 Ghritlaharey RK, Budhwani KS, Shrivastava DK. , et al. Trans-anal protrusion of ventriculo-peritoneal shunt catheter with silent bowel perforation: report of ten cases in children. Pediatr Surg Int 2007; 23 (06) 575-580
  • 14 Landisch RM, Colwell RC, Densmore JC. Infant gastrostomy outcomes: the cost of complications. J Pediatr Surg 2016; 51 (12) 1976-1982
  • 15 McSweeney ME, Kerr J, Jiang H, Lightdale JR. Risk factors for complications in infants and children with percutaneous endoscopic gastrostomy tubes. J Pediatr 2015; 166 (06) 1514-9.e1
  • 16 McSweeney ME, Jiang H, Deutsch AJ, Atmadja M, Lightdale JR. Long-term outcomes of infants and children undergoing percutaneous endoscopy gastrostomy tube placement. J Pediatr Gastroenterol Nutr 2013; 57 (05) 663-667
  • 17 Aprahamian CJ, Morgan TL, Harmon CM, Georgeson KE, Barnhart DC. U-stitch laparoscopic gastrostomy technique has a low rate of complications and allows primary button placement: experience with 461 pediatric procedures. J Laparoendosc Adv Surg Tech A 2006; 16 (06) 643-649
  • 18 Arthurs OJ, van Rijn RR. Paediatric and perinatal postmortem imaging: mortui vivos docent. Pediatr Radiol 2015; 45 (04) 476-477