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Catheter migration during home hyperalimentation.

SILASTIC catheters for long-term central venous angio-access have contributed to the efficacy of home hyperalimentation. They have decided advantages over conventional polyethylene and polyvinyl catheters, including flexibility without kinking, minimal thrombogenicity, and few septic complications.1 Our case report details the migration of a Silastic catheter after long-term permanent implantation, its clinical sequelae, and necessary therapeutic maneuvers. Report of a Case A 23-year-old man was admitted from another hospital after initial treatment for gangrenous midgut volvulus secondary to malrotation of the colon. After resolution of numerous complications, intestinal continuity was reestablished with a duodenocolostomy. Long-term home hyperalimentation was instituted after placement of a permanent Broviac Silastic subclavian catheter via the right cephalic vein. Catheter position in the right atrium was confirmed postoperatively by x-ray examination. After five months of asymptomatic, uneventful home parenteral nutrition, the patient noted the gradual onset of right-sided cervical and suprascapular pain, consistently accentuated by the