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Case Reports
. 2025 Apr 8;17(4):e81929.
doi: 10.7759/cureus.81929. eCollection 2025 Apr.

Hemodynamic Collapse Due to Unrecognized Hemothorax Following Central Venous Catheter Insertion in a Resource-Limited Setting: A Case Report

Gegal Pruthi  1 , Jyoti Kanwat  1 , Ruhi Sharma  1 , Gopal Jalwal  1
Affiliations
Case Reports

Hemodynamic Collapse Due to Unrecognized Hemothorax Following Central Venous Catheter Insertion in a Resource-Limited Setting: A Case Report

Gegal Pruthi et al. Cureus. .

Abstract

Central venous catheter (CVC) placement is a routine but not risk-free procedure, with potential complications including hemothorax. We present a case of a 71-year-old male with coronary artery disease (CAD) who developed intraoperative hemothorax following internal jugular vein CVC placement. The patient experienced profound hypotension during surgery, prompting intervention. Subsequent exploration revealed a small abrasion on the right lung surface caused by an inadvertent initial CVC puncture, leading to hemothorax. The patient was successfully resuscitated, and prompt identification and management of hemothorax were critical. This case emphasizes the importance of vigilance, communication, and early consideration of complications like hemothorax post-CVC placement when unexplained hemodynamic instability occurs. We believe that the use of ultrasonic guidance or fluoroscopic guidance during CVC placement could reduce unusual major mechanical complication rates even during emergencies.

Keywords: central venous catheterization; cvc; hemothorax; internal jugular vein; ultrasound.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. M mode measurement of left ventricular ejection fraction (LVEF): 50%
LV- left ventricle, RA- right atrium, LA- left atrium, IVS- interventricular septum, LVPW- left ventricular posterior wall, LVEDD- left ventricular end-diastolic diameter, LVESD- left ventricular end-systolic diameter
Figure 2
Figure 2. Long axis view of the internal jugular vein with the guidewire inside the lumen
Figure 3
Figure 3. Intraoperative arterial blood gas parameters (pH and lactates)
See this image and copyright information in PMC

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