Fibrin sheath of a peripherally inserted central catheter undepicted with gray-scale (real-time B-mode) ultrasonography: A case report

An 11-year-old male was admitted to our hospital with the acute exacerbation of chronic heart failure. A peripherally inserted central catheter (PICC) was inserted from the left forearm. Ten days after its insertion, the withdrawal of PICC was attempted because of occlusion. However, it was not possible to remove PICC because a fibrin sheath had attached around its tip. A color Doppler and probe compression technique revealed the presence of a fibrin sheath, which could not be detected by gray-scale (real-time B-mode) ultrasonography. This case demonstrated that the color Doppler and probe compression technique is useful for detecting a fibrin sheath. Keywords: Peripherally inserted central catheter, Fibrin sheath, Ultrasonography, Probe compression technique