Esophageal perforation caused by an indwelling central venous catheter

A 59 year old lady had just completed renal dialysis via a central venous catheter when she developed severe chest pain. She subsequently has severe haematemesis and emergency endoscopy showed a lesion in her esophagus consistent with the tip of her venous catheter, and extensive bleeding from the lesion. A chest X-ray was done which showed that her venous dialysis catheter tip position appeared to correspond with the site of the esophageal lesion. She received blood transfusion and was referred urgently to cardiothoracic surgery. Fortunately, the venous catheter moved spontaneously prior to any surgical intervention and the bleeding ceased. Thoracic CT scan showed the catheter tip back in the venous lumen and repeat endoscopy a few days later was normal. The venous catheter was subsequently replaced.