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Last updated: September 25, 2025View editorial policy

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Differential Diagnosis for PIV Leaking Bleeding

  • Single most likely diagnosis
    • Catheter malposition or dislodgement: This is the most common cause of leaking or bleeding from a peripherally inserted venous catheter (PIV), often due to improper placement or movement of the catheter.
  • Other Likely diagnoses
    • Catheter-related thrombosis: The formation of a blood clot around the catheter can lead to bleeding or leaking.
    • Infection: Local infection at the site of the PIV can cause inflammation, leading to bleeding or leaking.
    • Catheter damage: Mechanical damage to the catheter, such as a crack or puncture, can result in leaking.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Pulmonary embolism: Although less common, a pulmonary embolism can occur if a catheter-related thrombosis breaks loose and travels to the lungs.
    • Sepsis: Infection related to the PIV can lead to sepsis, a life-threatening condition.
    • Air embolism: Introduction of air into the venous system through the PIV can be fatal.
  • Rare diagnoses
    • Catheter-related arteriovenous fistula: An abnormal connection between an artery and a vein can form as a result of the catheter, leading to bleeding.
    • Venous perforation: The catheter can perforate the vein, causing bleeding into the surrounding tissue.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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