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VOLUME 21 , ISSUE 4 ( 2017 ) > List of Articles

CASE REPORT

Malposition of the central venous catheter: A diagnostic dilemma

Sameer N. Desai, Santosh K. Dasar, V Mithali

Keywords : Central venous catheter, complications, malposition

Citation Information : Desai SN, Dasar SK, Mithali V. Malposition of the central venous catheter: A diagnostic dilemma. Indian J Crit Care Med 2017; 21 (4):235-237.

DOI: 10.4103/ijccm.IJCCM_338_14

License: CC BY-ND 3.0

Published Online: 01-05-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

A 50-year-old male was admitted to Intensive Care Unit with head and chest injury needed multiple central venous catheter (CVC) for the long-term intravenous access. Right internal jugular vein was cannulated uneventfully, and the tip of CVC was confirmed in the chest radiograph along the right border of the mediastinum. After few days, left subclavian vein was cannulated and the procedure was uneventful. However, the postprocedure Chest X-ray showed the CVC along the left border of mediastinum rather than the right border. Possibility of CVC in one of the tributaries of left brachiocephalic vein was thought. Due to uncertainty in position of left CVC, we inserted CVC in right-sided subclavian vein, which was in normal position along the right border of mediastinum. Left subclavian CVC was removed. Reviewing the patient's thoracic computed tomography scan revealed, patient had congenital anomaly and double superior vena cava that explained the abnormal course of left subclavian CVC along the left border of mediastinum.


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  1. Gibson F, Bodenham A. Misplaced central venous catheters: Applied anatomy and practical management. Br J Anaesth 2013;110:333-46.
  2. Ghosh S, Dewan H, Bhattacharyya S. A rare malposition of the thoracic venous catheter introduced via the left internal jugular vein. Indian J Crit Care Med 2008;12:201-3.
  3. Ghatak T, Azim A, Baronia AK, Muzaffar SN. Malposition of central venous catheter in a small tributary of left brachiocephalic vein. J Emerg Trauma Shock 2011;4:523-5.
  4. Tong MK, Siu YP, Ng YY, Kwan TH, Au TC. Misplacement of a right internal jugular vein haemodialysis catheter into the mediastinum. Hong Kong Med J 2004;10:135-8.
  5. Goyal SK, Punnam SR, Verma G, Ruberg FL. Persistent left superior vena cava: A case report and review of literature. Cardiovasc Ultrasound 2008;6:50.
  6. Cormier MG, Yedlicka JW, Gray RJ, Moncada R. Congenital anomalies of the superior vena cava: A CT study. Semin Roentgenol 1989;24:77-83.
  7. Azocar RJ, Narang P, Talmor D, Lisbon A, Kaynar AM. Persistent left superior vena cava identified after cannulation of the right subclavian vein. Anesth Analg 2002;95:305-7.
  8. Higgs AG, Paris S, Potter F. Discovery of left-sided superior vena cava during central venous catheterization. Br J Anaesth 1998;81:260-1.
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