Rare malposition of central venous catheter

Abstract

Introduction:Although placement of the central venous catheter is a routine procedure carried out by anesthesiologists, it carries a certain risk of complications. One of the complications is malposition, or inadequate catheter position. Case report: We present a case of the patient who was admitted to an intensive care unit due to head injury and blood vomiting. The central venous catheter was inserted through the right internal jugular vein. Due to haemodynamic instability and the need for fluid and blood infusion, a chest x-ray examination was not immediately performed to evaluate the position of the catheter. After the patient was stabilized, the test was performed and revealed that the tip of the catheter was not located in the superior vena cava but in the right subclavian vein. Conclusion: This case has shown that the misplacement of the central venous catheter tip is not unusual. Once in the venous system, even when it is not located in the superior vena cava, it can be used for initial fluid replacement and drug administration, and after the patient is stabilized, the repositioning or placement of a new catheter should be considered.

Keywords

• internal jugular vein
• subclavian vein
• malposition
• venous catheter