Case ReportPerforation of the superior vena cava 5 days after insertion of a central venous catheter through the left internal jugular vein

- Vessel perforations are often associated with left-sided CVC insertions.
- We describe a rare case of an appropriately placed CVC perforating the SVC.
- The appropriate positioning of left-sided CVC tip is controversial.
- In some cases, the left innominate vein may be beneficial for the left-sided CVC.

We describe a very rare case of an indwelling central venous catheter (CVC) through the left internal jugular vein that perforated the superior vena cava (SVC) wall postoperatively, although the CVC was placed in the appropriate position preoperatively. Three days after CVC insertion, a chest radiograph showed that the CVC tip had moved from the lower SVC to the upper SVC. Five days after the insertion, computed tomography showed SVC perforation and the resulting hydrothorax. In cases of CVC insertion through the left side, the CVC tip should not be placed in the upper SVC (zone B). Considering individual clinical factors and the indwelling period for the CVC, the left innominate vein (zone C) may be a suitable site for the left-sided CVC tip to reduce the risk of SVC perforation.