IntroductionCentral venous access devices are widely used in hospital practice. Complications associated with their use are well described and reviewed. In this paper, we report a former complication that in turn created a new complication during a standardized procedure.Case presentationWe report the case of an 81-year-old Caucasian woman requiring total parenteral nutrition due to a high-debt enterocutaneous fistula. In a previous right subclavian catheterization a fragmentation of the tip of the catheter, probably not recognized at the time, provoked an extrinsic compression of the vessel.ConclusionFragmentation of a central venous catheter is a possible complication of catheterization and can be missed. Control of a catheter is imperative after its removal, even if not always practiced.

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Transomental internal hernias are a rare cause of intestinal obstruction and most commonly iatrogenic, resulting from previous surgical interventions, abdominal trauma or inflammation. Occasionally, they may occur spontaneously. We report the case of a 44-year-old healthy male admitted to the emergency room with acute abdominal pain and vomiting, consistent with intestinal obstruction. An internal hernia of small bowel in the lesser sac was suspected after performing a computed tomography (CT) scan and emergent laparotomy confirmed herniation of a jejunal loop through a defect in the hepatogastric ligament, resulting in strangulation and requiring enterectomy. The patient had a favourable outcome and was discharged a few days after surgery. Both radiologists and surgeons must be aware of rare internal hernia subtypes, to avoid delays in diagnosis and treatment. Abdominal CT is the first-line imaging of choice, providing useful diagnostic hallmarks. Nevertheless, surgical exploration is typically essential to confirm the diagnosis, identify the defect and assess bowel viability.

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