Title : Fractured peripheral intravenous cannula retained in the cephalic vein: A rare case and successful surgical retrieval
Abstract:
Aim: To present a rare case of a fractured peripheral intravenous cannula retained within the cephalic vein, and to describe the successful surgical retrieval technique used to prevent potential complications associated with intravascular foreign body migration.
Methods: An 80-year-old male admitted for ERCP developed leakage around a peripheral cannula. On inspection, the cannula was found to have fractured, leaving a segment retained intravascularly. Clinical examination identified a firm, cord-like structure over the cubital fossa, localising the fragment within the cephalic vein. The patient underwent urgent retrieval under local anaesthesia. A lazy-S incision was used to expose the vein, followed by venotomy and extraction of the catheter fragment. The venous wall was closed using 9-0 Ethilon, and the wound was closed in layers.
Results: The retained cannula segment was successfully removed intact without intravascular migration or further fragmentation. The patient tolerated the procedure well, experienced no postoperative complications, and proceeded to ERCP as planned. Early intervention prevented potential adverse outcomes such as thrombosis, infection, or pulmonary embolism.
Conclusion: Fracture of peripheral intravenous cannulas is a rare but clinically important complication. Prompt recognition, application of a tourniquet to prevent distal migration, and timely surgical retrieval are essential to avoid serious morbidity. This case highlights the effectiveness of venotomy under local anaesthesia for removal of non-migrated peripheral cannula fragments.
