Central venous catheter fracture presenting as pain on flushing

Central venous catheters (CVC) are widely used in the care of chronically ill patients, particularly those with intestinal failure receiving long-term parenteral nutrition. Serious complications such as infection, obstruction and catheter related thrombus are well recognised. We report two patients who developed localized pain on flushing the catheter. Radiological investigation revealed fluid leakage from the CVC, from a fracture within the skin tunnel in one case, and from the intravascular segment, with venous backflow probably related to a sleeve thrombus, in the other.