Perforation of the superior vena cava 5 days after insertion of a central venous catheter through the left internal jugular vein

Kurabe, Miyuki; Watanabe, Tatsunori; Kohno, Tatsuro

doi:10.1016/j.jclinane.2016.02.002

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…A similar and rare case of a central venous catheter (CVC) inserted through the left internal jugular vein that perforated the superior vena cava (SVC) wall was also reported by Kurabe M et al 10 In our case diagnostic CT scan done for chest pathology incidentally showed mal positioned central line. This could be the probable cause of increasingly worrisome symptoms of tachypnea and precordial pain, both of which improved gradually after CVC removal.…”

Section: Discussionsupporting

confidence: 78%

Very rare and serious complication of central line insertion

Sood¹

2019

IJCA

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Central venous catheter (CVC) placement is indicated for various therapeutic and diagnostic purposes. However, it is important to ensure its proper placement. A CVC malposition is associated with number of recognized complications, some of which can be fatal. Case: In a 27 year female admitted in ICU with history of seizures and oral bleed with stable vitals, 7Fch subclavian CVC was inserted. She had progressive dyspnea, chest pain and hypotension. Although chest X-ray showed correctly positioned CVC, CECT chest showed it was entering SVC, traversing along its medial wall and reaching between SVC and aorta and entering in the right atrium. Also atelectic fluid in oblique fissure, bilateral pleural effusion and small pocket of air in anterior mediastinum with minimal mediastinal high attenuation collection was seen. This was removed and patient was under observation for 24 hours, after which she was shifted to ward. Conclusion: Therefore location of the catheter must be verified by radiological methods. Also real-time ultrasound reduces the number of complications associated with the technique.

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Section: Discussionsupporting

confidence: 78%

Very rare and serious complication of central line insertion

Sood¹

2019

IJCA

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“…A few cases of venous rupture during placement of a central venous line using internal jugular access have been reported. [3][4][5][6] However, this is a rare case demonstrating injury to the right subclavian vein using internal jugular access. Systemic hypertension, diabetes mellitus, obstructive sleep apnea, chronic renal disease, and morbid obesity (body mass index of 44.26 kg/m²).…”

Section: Introductionmentioning

confidence: 99%

Subclavian vein injury during placement of the right internal jugular dialysis catheter

Baiomy

Abdelsalam

2021

AJIR

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“…The central line is required in patients on repeated intermittent drug therapy, regular transfusions, total parenteral nutrition (TPN), and chemotherapy [1] , [2] , [3] , [4] . However, CVC and PICC may cause several complications, such as pneumothorax and arterial punctures, during the insertion procedure, as well as delayed complications, such as infection, thrombosis, fracture and embolization, catheter migration, venous erosion, and hydrothorax or hydromediastinum [5] , [6] , [7] . According to previous reports, vascular erosions are most commonly associated with left-sided CVC insertions used in intensive care units to administer fluids, medications, and blood products [5] , [8] , [9] .…”

Section: Introductionmentioning

confidence: 99%

“…However, CVC and PICC may cause several complications, such as pneumothorax and arterial punctures, during the insertion procedure, as well as delayed complications, such as infection, thrombosis, fracture and embolization, catheter migration, venous erosion, and hydrothorax or hydromediastinum [5] , [6] , [7] . According to previous reports, vascular erosions are most commonly associated with left-sided CVC insertions used in intensive care units to administer fluids, medications, and blood products [5] , [8] , [9] . Here, we describe a rare case involving hydropneumomediastinum and hydropneumothorax as a delayed complication of right-sided PICC used for TPN.…”

Section: Introductionmentioning

confidence: 99%

Hydromediastinum and hydrothorax as delayed complications of peripherally inserted central catheter used for total parenteral nutrition: A case report

Chica

Ballén

Aguillon

et al. 2021

International Journal of Surgery Case Reports

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Introduction Central venous catheters (CVCs) and peripherally inserted central catheters (PICCs) may cause delayed complications, such as venous erosion, hydrothorax, or hydromediastinum. Vascular erosion is most frequently associated with left-sided CVC insertions. We report a case of hydropneumomediastinum and hydropneumothorax as a delayed complication of right-sided PICC used for total parenteral nutrition. Presentation of case A 77-year-old man with muscle-invasive urothelial bladder cancer underwent pelvic lymphadenectomy and radical cystectomy with uretero-ileostomy reconstruction (Bricker). The patient developed postoperative ileus, and thus, a right PICC was inserted for total parenteral nutrition. On postoperative day 8, he developed bilateral hydromediastinum, and bilateral thoracentesis was performed. After the procedure, he presented with respiratory and hemodynamic deterioration and was transferred to the intensive care unit for 12 days. The patient was eventually discharged and followed-up at the outpatient department. Discussion Ruptured SVC has been predominantly described in left-sided CVCs at the right angle of the junction of the left brachiocephalic vein and SVC. However, our patient is the second documented case of bilateral hydropneumothorax and hydropneumomediastinum as a delayed complication of a PICC used to administer total parenteral nutrition. Catheters may migrate from their initial position due to breathing, bloodstream flow dynamics, postural rotation, and neck movements. Chemical irritation of the vessel wall may be caused by hyperosmolar hyperalimentation fluid. Conclusion A right-sided vascular approach is preferred to avoid friction complications, and the tip should be placed at the lower third of the vena cava to prevent vascular erosion.

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Perforation of the superior vena cava 5 days after insertion of a central venous catheter through the left internal jugular vein

Cited by 7 publications

References 11 publications

Very rare and serious complication of central line insertion

Very rare and serious complication of central line insertion

Subclavian vein injury during placement of the right internal jugular dialysis catheter

Hydromediastinum and hydrothorax as delayed complications of peripherally inserted central catheter used for total parenteral nutrition: A case report

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