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Case 152: Oncology patient

You are asked to take blood from this patient but cannot find a suitable vein for venepuncture. You notice a scar on the anterior chest wall and an unusual finding in the lower neck.

1. What have you found?

A buried subcutaneous infusion port for vascular access. Usually used for chemotherapy. Sometimes known as an infusaport.

2. What problems do these devices have?

Insertion: bleeding, pneumothorax, failure, difficult to feed into central vein, arrhythmia

Medium term: infection, sepsis, blockage, thrombosis, pulmonary embolus, port volvulus and inability to needle port, extravisation of chemo and resulting skin necrosis.

Removal: bleeding, breakage of catheter and foreign body pulmonary embolus, air embolus, seroma, infection.

See a similar case: Case 111

PubMed - Longterm central venous access in gynecologic cancer patients.