Delayed perforation of the innominate vein during hyperalimentation.

Mechanical complications of central vein catheterization for hyperalimentation typically become manifest shortly after insertion. We present a case report describing a delayed innominate vein perforation by a central venous catheter. Use of the adult internal jugular vein for central venous catheterization should be limited to situations in which a subclavian vein is unavailable. Ongoing watchfulness and a vigorous diagnostic and therapeutic approach to such complications are mandatory in the treatment of patients receiving total parenteral nutrition.