Intraoperative Peripheral Intravenous Catheter Fracture During Modified Radical Neck Dissection.

Peripheral intravenous catheter (PIVC) fracture is a rare but potentially serious iatrogenic complication associated with intravascular fragment retention and embolic risk. We report a 67-year-old man undergoing modified radical neck dissection in whom the abrupt cessation of infusion revealed a fracture of an 18-gauge PIVC placed on the dorsum of the hand. Ultrasonography confirmed retained intravascular fragments. Surgical exploration under ongoing general anesthesia identified and successfully retrieved three fractured catheter segments within 10 minutes. The patient recovered uneventfully. This case emphasizes the importance of careful intraoperative catheter monitoring, awareness of mechanical compression risk -- including avoidance of placing a non-invasive blood pressure cuff on the same limb as the operative catheter -- and prompt imaging-guided management of suspected catheter fracture.