[Central venous catheter as a reason of bleeding after tracheotomy]

Area of Science:

• Vascular Surgery
• Anesthesiology
• Critical Care Medicine

Background:

• Tracheotomy is a common surgical procedure with potential complications, including bleeding.
• Central venous catheterization is frequently used in perioperative settings for monitoring and treatment.

Observation:

• A patient undergoing tracheotomy experienced intraoperative bleeding initially attributed to heparin therapy.
• Postoperatively, the central venous catheter, inserted into the external jugular vein, was found to have migrated and eroded the anterior jugular vein wall.
• The catheter tip was later visualized within the tracheotomy site, indicating a significant complication.

Findings:

• The bleeding complication was directly caused by the malpositioned central venous catheter eroding the anterior jugular vein.
• Surgical ligation of the damaged anterior and external jugular veins was required for hemorrhage control.
• Removal of the dislocated catheter was essential to resolve the bleeding and prevent further injury.

Implications:

• This case highlights a rare but serious complication of central venous catheterization during tracheotomy.
• It underscores the importance of vigilant monitoring of catheter position and prompt diagnosis of malposition-related bleeding.
• Accurate identification and surgical management are crucial for addressing such vascular injuries in patients undergoing tracheotomy.