title: Perforation of the superior vena cava 5 days after insertion of a central venous catheter through the left internal jugular vein.
abstract: We describe a very rare case of an indwelling central venous catheter (CVC) through the left internal jugular vein that perforated the superior vena cava (SVC) wall postoperatively, although the CVC was placed in the appropriate position preoperatively. Three days after CVC insertion, a chest radiograph showed that the CVC tip had moved from the lower SVC to the upper SVC. Five days after the insertion, computed tomography showed SVC perforation and the resulting hydrothorax. In cases of CVC insertion through the left side, the CVC tip should not be placed in the upper SVC (zone B). Considering individual clinical factors and the indwelling period for the CVC, the left innominate vein (zone C) may be a suitable site for the left-sided CVC tip to reduce the risk of SVC perforation.
authors.affiliation: Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. Electronic address: miyuki915@med.niigata-u.ac.jp.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Kurabe
authors.affiliation: Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Kohno
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006876:Hydrothorax / Q000209:etiology; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D010051:Ovarian Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000293:injuries*
keywords: Central venous catheter; Left internal jugular vein; Perforation