Superior vena cava thrombosis causing respiratory obstruction successfullyresolved by stenting in a small bowel transplant candidate

A 4 year old child was referred for small bowel transplantation. He had sup erior vena cava obstruction secondary to numerous central venous line place ments; alternative routes for long term central venous access were compromi sed by extensive venous occlusive disease. Patency for the superior vena ca va was reestablished with stenting, which allowed for radiological placemen t of another central venous line. Long term survival in infants and young children with intestinal failure is dependent on adequate central venous access for the administration of pare nteral nutrition. Line sepsis and physical damage to the catheter often nec essitates multiple central venous catheter placements during their early li fe and these children are at risk of catheter related veno-occlusive diseas e. Recurrent sepsis and the loss of satisfactory venous access for the admi nistration of parenteral nutrition is Life threatening and is an indication for intestinal transplantation in up to 41% of patients reported by the sm all bowel registry.