Interdisciplinary Collaboration for the Management of Peripherally Inserted Central Catheter Rupture Resulting From Malposition During Esophageal Cancer Surgery After Neoadjuvant Therapy: A Case Report

This case report describes an intraoperative rupture of a peripherally inserted central catheter (PICC) that had inadvertently advanced into the azygos vein during esophagectomy for cancer after neoadjuvant therapy. The intraoperative analysis and discussion of the cause of the malpositioned PICC in this case, along with interdisciplinary collaboration, led to the successful removal of the ruptured PICC from the azygos vein. Postoperatively, the authors conducted a thorough literature review to elucidate the mechanisms underlying PICC malposition into the azygos vein. Based on this analysis, the authors have proposed a series of preventive measures and predictive management recommendations aimed at reducing the risk of both central-venous catheter malposition and device fracture. This case report may provide valuable insights for the management of similar events during surgery in the future.