Mediastinal Haematoma: A Rare Complication Following Insertion of Central Venous Catheter
Pankaj Gupta, Sandeep Guleria
Citation Information :
Gupta P, Guleria S. Mediastinal Haematoma: A Rare Complication Following Insertion of Central Venous Catheter. Indian J Chest Dis Allied Sci 2011; 53 (4):225-228.
Mediastinal haematoma is a rare complication following insertion of central venous catheter, with few cases reported in the literature. We report a case of mediastinal haematoma in a 33-year-old male patient with end-stage renal disease. In this patient central venous catheter insertion through the right subclavian vein was attempted on the operation table for renal transplantation but the procedure was abandoned as the attempt was unsuccessful. Post-procedure chest radiograph showed a large mediastinal haematoma occupying right hemithorax that developed as a result of injury to the subclavian vein. Patient was managed conservatively and haematoma completely resolved in four weeks time. This case is being reported to signify the importance of routine obtaining a post-procedure chest radiograph and to state that even large mediastinal haematoma can be managed conservatively in asymptomatic patients.
Naguib M, Farag H, Joshi RN. Bilateral hydrothorax and hydromediastinum after a subclavian line insertion. Canadian Anaesth Soc J 1985;32:412-4.
Arik N, Akpolat T, Demirkan F, Demirkazik F, Yasavul U, Turgan T, et al. Mediastinal hematoma: a rare complication of subclavian catheterization for haemodialysis. Nephron 1993;63:354.
Chemelli AP, Chemelli-Steingruber IE, Bonaros N, Luckner G, Millonig G, Seppi K, et al. Coil embolization of internal mammary artery injured during central vein catheter and cardiac pacemaker lead insertion. Eur J Radiol 2009;71:269-74.
Hohlrieder M, Oberhammer R, Lorenz IH, Margreiter J, Kühbacher G, Keller C. Life-threatening mediastinal hematoma caused by extravascular infusion through a triple-lumen central venous catheter. Anesth Analg 2004; 99:31-5.
Doi A, Iida H, Saitoh Y, Sunazawa T, Tajika Y. A posterior mediastinal hematoma causing tracheal obstruction after internal jugular cannulation for cardiac surgery. J Cardiothorac Vasc Anesth 2009;23:682-3.
Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 2001;286:700-7.
Oliver WC Jr, Nuttall GA, Beynen FM, Raimundo HS, Abenstein JP, Arnold JJ. The incidence of artery puncture with central venous cannulation using a modified technique for detection and prevention of arterial cannulation. J Cardiothorac Vasc Anesth 1997;11:851-5.
Carr M, Jagannath A. Hemopericardium resulting from attempted internal jugular vein catheterization: a case report and review of complications of central venous catheterization. Cardiovasc Intervent Radiol 1986;9:214-8.
Sato O, Tada Y, Sudo K, Ueno A, Nobori M, Idezuki Y. Arteriovenous fistula following central venous catheterization. Arch Surg 1986;121:729-31.
Schummer W, Schummer C, Fröber R. Internal jugular vein and anatomic relationship at the root of the neck. Anesth Anals 2003;96:1540.
