Malpositioning of Central Venous Catheter from Right Internal Jugular Vein into Ipsilateral Vertebral Vein: A Rare Phenomenon

Abstract

Introduction: Central venous catheter insertions are being increasingly practiced by anaesthesiologists
in major surgeries involving haemodynamic changes and massive fluid shifts. A common complication is
misplacement of central line in intravenous territory which requires prompt identification and correction.
Case Report: The present case report describes a landmark guided CVC insertion done prior to surgery in a
70 year old patient with multiple stones in right renal pelvis and bilateral ureters with consequent right sided
hydronephrosis and obstructive renopathy. Despite venous backflow from all 3 ports, chest X-ray showed
central line folding upon itself directed upwards at the level of transverse process of 7th cervical vertebra
which was confirmed on colour doppler to be in right vertebral vein.
Conclusion: Malpositions of central venous catheters are common and call for USG guidance to be made
mandatory in every institute where USG is available.