Azygos vein erosion: A potential complication of central venous access

Central venous access is a common procedure that is performed for a variety of reasons. However, occasionally these lines can be misplaced at an improper anatomic location despite fluoroscopic guidance. Here we present a pediatric case in which a central venous port appeared correctly located on anterior-posterior (AP) fluoroscopic view. However, it was later discovered on lateral views that the catheter was placed in the azygos vein. The catheter eroded through the azygos vein and into the pleural space. This article highlights the importance of proper technique when placing central lines and discusses additional techniques and avenues of research in order to prevent this complication in the future.