Delayed Malposition of Central Venous Catheter Induced Mediastinum Hematoma With Innominate Vein Perforation.

Central venous catheterization (CVC) is a common invasive procedure. Although it is a relatively safe procedure, severe complications occurred sometimes. One of the most serious complications is large vessel perforation. A 40-year-old man was send to intensive care unit (ICU) after liver transplantation surgery with massive blood transfusion. Four days later, chest computed tomography (CT) were arranged for unknown leukocytosis and high level of procalcitonin. Chest CT revealed possibility of innominate vein perforation by CVC. Surgeon confirmed the malposition of CVC complicated perforation and repaired innominate vein. Unfortunately, the patient passed away 8 days later after this re-operation even initially better condition after aggressive treatment. Delayed malposition of CVC is a rare cause for CVC complications. To minimize incidence of this severe complication, catheterization should be performed very carefully and post-procedure position checking is indicated.