Case Report: Case report: Catheter rupture and migration into the pulmonary artery: A surgical intervention following failed percutaneous retrieval

Résumé

Port catheters are commonly used in oncology for chemotherapy, but they can sometimes rupture and migrate, leading to serious complications. Early detection and management are crucial, and surgical intervention may be required when less invasive approaches fail. This report highlights these rare but significant complications. A 57-year-old male, with no significant medical history, underwent surgery for sigmoid colon adenocarcinoma and planned chemotherapy. His port catheter became nonfunctional, and on presentation, he was hemodynamically stable with normal vital signs. Chest radiography revealed catheter rupture, and thoracic angio-CT confirmed the fragment’s migration into the left pulmonary artery. After a failed percutaneous attempt, emergency surgery was performed via median sternotomy, successfully retrieving the catheter fragment. Catheter rupture and migration are rare complications, with an incidence of less than 1%. The clinical presentation can vary from asymptomatic to severe, requiring a high index of suspicion. Imaging, including chest radiography and thoracic angio-CT, is essential for accurate diagnosis and treatment planning. Management options include percutaneous retrieval, but surgery may be necessary when complications arise, as in this case. Preventive strategies, such as proper insertion and regular surveillance, are key in minimizing risks. Catheter rupture with migration is a life-threatening complication that requires urgent diagnosis and intervention. This case underscores the importance of vigilance in monitoring oncology patients with implantable devices and emphasizes the critical role of surgical intervention when less invasive approaches fail.

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