Intraperitoneal extravasation of total parenteral nutrition: A rare but life-threatening complication of umbilical vein catheter, two case reports

Umbilical vein catheter (UVC) is a commonly used intervention in neonatal intensive care units for total parenteral nutrition (TPN), antibiotic therapy, and investigations, especially in very low birth weight infants. In this report, a rare but life-threatening complication of UVC developed in two preterm infants was presented. Of two infants admitted to our neonatal intensive care unit due to prematurity, the first infant developed abdominal distension and a decreased urinary output on the 2nd day and the second infant on the 5th day. Enteral intake of the patients was discontinued with the presumed diagnosis of necrotizing enterocolitis, and broad-spectrum antibiotic therapy was initiated. There were free ascites on the abdominal ultrasonography. Macroscopic and microscopic examination of the fluid sample taken by paracentesis was compatible with TPN. Intraperitoneal extravasation of UVC, which is a rare but life-threatening complication of UVC and can be confused with necrotizing enterocolitis, should be kept in mind, especially in infants receiving TPN infusion from the UVC.