# Hemothorax Complicating Hickman Line Placement in a Pediatric Patient: A Case Report of Early Recognition and Management

## TL;DR

A one-year-old with SCID developed a life-threatening hemothorax during Hickman line placement, emphasizing the need for early recognition and quick action.

## Contribution

This case report highlights a rare but critical complication during central venous catheter placement in a pediatric patient.

## Key findings

- A hemothorax occurred during Hickman line placement in a pediatric patient with SCID.
- Prompt resuscitation and chest tube insertion stabilized the patient after a large blood loss.
- Early recognition and intervention were crucial in managing this complication.

## Abstract

Central venous catheters (CVCs) are essential in managing pediatric patients requiring long-term venous access, particularly for bone marrow transplantation (BMT). Although generally safe, their insertion is not without risks. We report the case of a one-year-old boy with Severe Combined Immunodeficiency Disorder (SCID) who developed a life-threatening right-sided hemothorax during Hickman line placement. The patient presented with acute hemodynamic instability and pulseless electrical activity (PEA) following multiple failed cannulation attempts. Immediate resuscitation measures restored circulation, and imaging revealed a large hemothorax. A chest tube was inserted, draining 138 mL of blood, leading to clinical stabilization. This case highlights the importance of early complication recognition, imaging, and prompt intervention during central venous catheterization.