Secondary migration: a complication of Hickman central venous catheters

We report two patients with spontaneous intrajugular migration of Hickman catheters which were initially correctly placed with the tip in the right atrium, via the right subclavian vein. In one patient the catheter remained in situ for 40 days without any sequelae; in the second patient the catheter was removed immediately. In the first patient two interim chest radiographs disclosed the catheter's course suggesting a possible mechanism of migration. Since early detection of this complication allows interventional repositioning, periodic monitoring of indwelling catheters by chest X-ray is recommended.