Massive Hemothorax Post Central Venous Line Removal: A Case Report

Hemothorax is uncommon complication of central venous catheterization. Although it often develops immediately after the procedure, it is very rare after removal of the central catheter. A 33-year-old female patient is scheduled for septoplasty under general anesthesia. Before the start of surgery, she developed hypotension (70/50 mmHg) and desaturation (PO2 down to 85%). The provisional diagnosis was anaphylaxis. A central venous catheter (CVC) was inserted into the right internal jugular vein (IJV) by the Seldinger technique with ultrasound guidance. The patient improved after hemodynamic correction for 24 hours. A few minutes after removal of the catheter in the intensive care unit, the patient developed acute chest pain and dyspnea. Chest X-ray and computed tomography revealed a massive right-sided hemothorax requiring urgent chest tube insertion with evacuation of two liters of blood. The patient improved clinically, the chest tube was removed after 3 days, and she was discharged in stable condition. Although massive hemothorax is very rarely reported after CVC removal, all cases with IJV catheter removal should be carefully monitored for an appropriate period.