PNEUMO-INFUSO-MEDIASTINUM AFTER VENOUS-WA LL-PERFORATION OF A PORT-A-CATH-SYSTEM - A RARE COMPLICATION

A sixty-hive years old woman with breast carcinoma and liver metastase s was hospitalized because of leuco- and thrombocythaemia, weakness an d fever after the end of a chemotherapy-course. The patient was nouris hed and treated with antibiotics intravenously by a four weaks ago imp lanted Port-a-cath-system. On her eigth stationary day her condition g ot worse with an acute dyspnea. The chest-X-ray revealed a broad media stinum, pneumomediastinum, and the dislocation of the catheter. An ede ma of the mediastinum with distant vessels and air-enclosures were fou nd in CT. The dislocation of the Port-a-cath-tip was proven by injecti on of contrast medium. During diuretic therapy clinical and radiologic al symptoms were quickly declining and the Port-a-cath-system was expl anted without complications. The penetration of a Port-a-cath-tip thro ugh a venous wall is a rare mechanical complication that causes a pneu mo-infuso-mediastinum, Chest X-ray, injection of contrast medium into the Port-a-cath-system and CT illustrate the catheter-penetration very well.