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Esophageal perforation after catheterization of the subclavian vein

Florian Weis1, Andres Beiras-Fernandez, Sebastian Sadoni

  • 1Department of Anesthesiology, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany.

The Heart Surgery Forum
|September 11, 2008
PubMed

Insights

Central venous catheter (CVC) insertion via subclavian vein can cause esophageal lesions and pneumothorax. Prompt treatment with endoclips and pleural drainage saved the patient from these immediate CVC complications.

Area of Science:

  • Medical procedures
  • Vascular access
  • Interventional techniques

Background:

  • Central venous catheter (CVC) insertion, particularly via the subclavian vein, is a common medical procedure.
  • Subclavian CVC placement is associated with potential complications, necessitating careful technique and monitoring.

Observation:

  • A case report details a patient experiencing an esophageal lesion with severe bleeding and a pneumothorax with mediastinal shift during CVC insertion.
  • The complications arose specifically from the insertion of the CVC's dilator.

Findings:

  • The induced pneumothorax required immediate intervention with pleural drainage.
  • The esophageal lesion was successfully managed and repaired using an endoclip.

Implications:

  • This case highlights rare but serious complications associated with subclavian CVC insertion.
  • Effective management strategies for these complications include prompt pleural drainage and endoscopic repair.
  • While the immediate CVC-related complications were resolved, the patient later succumbed to unrelated multiple organ failure.

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