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Catheter-directed thrombolysis is a feasible and highly effective interventional procedure with an acceptable safety profile in selected patients with and without cancer for the treatment of symptomatic thoracic central venous thrombosis. In most cases, additional endovascular or surgical procedures are required to restore and maintain vessel patency after successful thrombolysis.

We report a 4-month-old boy who developed scrotal emphysema following removal of a chest drain. The initial diagnosis was made by ultrasonography. This report describes the sonographic findings, pathophysiological mechanisms and outcome of this rare entity.

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