Abstract
Long-term home parenteral nutrition (HPN) is an established treatment for chronic intestinal failure. A reliable and safe vascular access is of fundamental importance to HPN patients. We have typically used a right atrial catheter attached to a subcutaneous port. We present a case of right atrial catheter retraction in a large-breasted woman with short bowel syndrome. The catheter was retracted and coiled around the reservoir in the subcutaneous pocket by motion of the patient with large breasts. Displacement of right atrial catheters is a rare but recognized complication. To avoid this complication in obese patients with large breasts, the positional changes of the breast should be determined, and the reservoir should be implanted in the area of least motion along the sternum. (Journal of Parenteral and Enteral Nutrition 24:251-253, 2000)
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