Spontaneous migration of central venous catheter tip.

A 37 year old female diagnosed as a case of acute myeloid leukemia (AML) underwent allogenic stem cell transplant. A 12.5 French triple lumen Hickman's catheter was inserted via right internal jugular vein under fluoroscopic guidance. Post insertion X-ray confirmed desired position of the catheter tip (Fig. 1). Two days post insertion she developed mild pain in the nape of neck which increased gradually and examination revealed spasm of right trapezius muscle and tenderness at the level of right mastoid tip. On repeat X-ray the catheter tip was seen in cephalad direction in the internal jugular vein (Fig. 2).There was no swelling or any evidence of fluid extravasation. The Hickman's catheter was then removed and another central venous catheter inserted through the left internal jugular vein. The patient underwent stem cell transplant successfully and was discharged in good condition.