Abstract:
Background: Hemothorax is a rare but life-threatening complication of central venous catheterization. Recent reports suggest that ultrasound guidance may reduce complications however, it does not guarantee safety.
Case summary: A 75-year-old male patient was admitted for laparoscopic radical nephrectomy. Under ultrasound guidance, right internal jugular vein catheterization was successfully achieved after failure to aspirate blood from the catheter in the first attempt. Sudden hypotension developed after surgical positioning and persisted until the end of the operation, lasting for about 4 h. In the recovery room, a massive hemothorax was identified on chest radiography and computed tomography. The patient recovered following chest tube drainage of 1.6 L blood.
Conclusion: Hemothorax must be suspected when unexplained hemodynamic instability develops after central venous catheterization despite ultrasound guidance. So the proper use of ultrasound is important.
Reference:Kang H, Cho SY, Suk EH, Ju W, Choi JY. Massive hemothorax following internal jugular vein catheterization under ultrasound guidance: A case report. World J Clin Cases. 2022 Jun 16;10(17):5776-5782. doi: 10.12998/wjcc.v10.i17.5776. PMID: 35979121; PMCID: PMC9258369.
