제대동맥삽관술과 연관된 신생아의 대동맥 혈전증: 임상 및 초음파 검사 소견

Abstract

PURPOSE : To evaluate the clinical findings and ultrasonographic findings of aortic thrombosis which developed after umblical artery catheterization in neonates. METHODS : We retrospectively evaluated clnical records and ultrasonographic findings in five cases of aortic thrombosis, which developed after umblical artery catheterization. Four were premature newborns, and one was a term neonate but small for gestational age. Three were male infants. The mean age was 29.8 days (15-71 days) and the duration of umblical artery catheterization was 16.4 days (7-31 days). The gestational age of 5 cases was between 26 and 38 weeks (mean 33 weeks) and birth weight was between 930 and 2,600 g (mean 1,950 g). All cases were diagnosed by ultrasonography only, and in 2 cases color Doppler ultrasonography was performed additionally. RESULTS : There were several associated conditions including hypothermia (n=2), perinatal asphyxia (n=2), respiratory distress syndrome (n=5), and neonatal infection (n=5). The clinical manifestations of 5 cases were hypertension (n=4), thrombocytopenia (n=4), hematuria (n=2), renal failure (n=l), and congestive heart failure (n=l). In all five cases, ultrasonography showed hyperechoic thrombus with partial occulsion of aorta. The size of thrombi varied 1.2-4x 4-25 mm. All thrombi were located around the origin site of renal artery. CONCLUSION : Aortic thrombosis, one of the complications of umblical artery catheterization can easily be diagnosed by ultrasonography, so ultrasonography would be needed as a screening study in neonate with umblical artery catheterization.