Bilateral Chest Injury after Landmark-Guided Difficult Central Venous Cannulation-a Case Report

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Nora Mihalek
Katarina Krstic
Sanja Starcevic
Dragana Radovanovic
Gabor Erdoes


Central venous catheter placement is a high-risk procedure in anesthesia practice. We report a case of bilateral chest injury after difficult central venous catheter placement according to the landmark technique. Thirty hours after central venous catheter placement, the patient developed a right-sided hydrothorax (secondary to malposition of the central venous catheter) and a left-sided pneumothorax (secondary to multiple attempts at central venous catheter insertion). The patient was intubated and bilateral chest drainage was performed. This report underlines the importance of avoiding bilateral central venous puncture and highlights the importance of proper diagnostics to detect post-intervention complications.

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Case reports


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