Accidental intraperitoneal malpositioning of femoral central venous catheter: Learning from mistakes

Abstract

A large number of central venous catheters (CVC) are placed each year in the emergency room, operation theatre and critical care unit. Although rarely associated with life threatening complications, femoral CVC is known to have the highest incidence of mechanical complications. It is important that clinicians are aware of wrong positioning of CVC even in the presence of good backflow of blood through all the lumens, especially in patients with haemo peritoneum. This article outlines a rare complication of misplaced femoral CVC into the peritoneal cavity in a patient with haemo peritoneum, its consequences and management. We further want to emphasize the importance of real time imaging during CVC insertion to improve safety and reduce complications rate.

Ultrasound Guidance for Central Venous Access: Current Evidence and Clinical Recommendations

“…Other complications include nerve injury or paresthesia during the procedure and thrombus within the femoral or iliac veins. Rare complications include malposition into the retroperitoneal space, 60 intraperitoneal space, [61][62][63] and bladder. 64 Recent recommendations pertaining to ultrasound guidance for CV cannulation are summarized in Table 1.…”