Servetar EM. A case report of Twiddler’s syndrome in a pediatric patient. J Ped Oncol Nursing
1992;9,1(Jan);25-28.

Twiddler’s syndrome, the migration of a catheter tip out of a vessel by intentional or unintentional self-manipulation, is presented in a case report of a young child with Langerhans’ cell histiocytosis. Since this migration is a potentially serious complication of internal venous catheters, an overview compares and contrasts the differences between internal an external central venous catheters. The need to consider Twiddler’s syndrome in an assessment of a patient with an internal venous catheter is emplhazsized. …In this case, a noninvasive chest roentgenogram could easily have avoided the complication of extravasation. The port would still have been removed, but the patient would not have experienced the pain associated with infiltration. …Despite this episode, [the patient’s] parents continue to feel that the implanted port has decreased the trauma of routine venipunctures for their son and has alleviated their anxiety about venous access.

Abstracted by permission from the Journal of Pediatric Oncology Nursing,
© 1992 by the Association of Pediatric Oncology Nurses.