Silent port catheter fracture with normal infusion: A case report and literature review.

RATIONALE: Although the totally implantable venous access ports have been widely used for chemotherapy and parenteral nutrition because of their safety and durability, some postoperative complications may still occur, such as catheter fracture, which can occur so silently and be discovered after several cycles of chemotherapy. PATIENT CONCERNS: A 55-year-old male received the implantation of a chest wall venous port via the right internal jugular vein approach in an external hospital more than 3 years ago due to the need for chemotherapy for pancreatic cancer. On the 1221st catheter day, blood return could not be aspirated. DIAGNOSES: A chest X-ray confirmed the catheter rupture. INTERVENTIONS: An emergency endovascular surgery was performed to remove the ruptured catheter and the port body, and a new venous port was implanted. OUTCOMES: Upon careful review of the medical history, the patient could not feel the cord-like structure in front of the right clavicle 3 months ago. Since the previous chemotherapy sessions had gone smoothly, the patient did not pay much attention to it. This also implies that the catheter rupture might have occurred at that time. Moreover, several chemotherapy infusions were still carried out after the catheter rupture, and the patient did not experience any discomfort. LESSONS: The catheter rupture of venous ports can present silently, meaning the port can still be used for smooth infusion without any patient's discomfort, which precisely delays the diagnosis, and may lead to life-threatening complications such as pulmonary embolism. Standardized maintenance of the venous port, regular chest imaging examinations, and careful interpretation of the imaging findings are helpful for the early diagnosis of such silent catheter ruptures.