Trousseau syndrome is a venous thromboembolic complication found in abdominal cancer patients. A 46-year-old woman diagnosed with and treated for pulmonary embolism due to Trousseau syndrome with a huge ovalian tumor was planned to undergo oophorectomy. She presented with pulmonary hypertension and her inferior vena cava was compressed by the tumor. After induction of general anesthesia, ultrasound-guided central venous catheterization (CVC) to her right internal jugular vein was tried. The guidewire was misplaced in the vertebral vein through the right internal jugular vein. Her vertebral vein was abnormally dilated. The dilated vertebral vein was supposed to have worked as a venous perfusion route from the lower extremities. When the CVC was performed in patients with restricted venous return due to Trousseau syndrome, deep-seated veins as well as arteries should be checked with ultrasonography.
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