Carotid artery puncture is a common complication of internal jugular vein (IJV) catheterization. However, there are few reports about an aneurysm from the carotid artery that can develop into an occult mediastinal hematoma, leading to airway compression. In this case study, we present the case of a 71-year-old male who experienced an aneurysm and delayed mediastinal hematoma, ultimately resulting in airway compression after right jugular line insertion. Our findings highlight the importance of not only addressing local hematoma formation at the puncture site promptly, but also recognizing the potential for aneurysm extension into the mediastinum and the formation of an occult hematoma, which can lead to airway compression. Additionally, we provide a summary of landmark technique precautions that can help reduce the occurrence of such severe complications.

Arteriovenous fistula (AVF) are the preferred hemodialysis vascular access. However, central venous catheter (CVC) placement rates remain very high in patients initiating hemodialysis and/or in whom with a fistula dysfunction. Several complications are associated with the insertion of these catheters, including infection, thrombosis and arterial injuries. Iatrogenic AVF are uncommon complications. Herein, we report the case of a 53-year-old female with an iatrogenic right subclavian artery - internal jugular vein fistula secondary to a right internal jugular catheter malposition. Through a median sternotomy combined with supraclavicular approach, AVF exclusion with direct suture of subclavian artery and the internal jugular vein was performed. The patient was discharged without any complications.

BACKGROUND: Placement of a central venous catheter (CVC) is a common procedure for spinal surgery and is relatively safe under ultrasound guidance.
METHODS: We report the case of a 56-year-old female who underwent ultrasound-guided placement of an internal jugular vein CVC for fluid replacement during spinal surgery for thoracic vertebral burst compression fracture and multiple rib fractures as a result of a high-altitude fall injury. Hemothorax developed intraoperatively. During a thoracotomy, the tip of the CVC was found within the chest cavity. The presence of chest trauma may impact on clinician\'s appreciation of the potential complications of internal jugular vein CVC placement.
CONCLUSIONS: The present case demonstrates the need for clinical awareness of the potential complications of CVC placement in patients with chest trauma and the need for adequate training in this technique.