Abstract:
INTRODUCTION : Surgeons employ central venous catheterization as a therapeutic or preventive measure in the pediatric
population. These catheters are introduced into the internal jugular, subclavian, or femoral veins using
the central approach, involving the insertion of the needle into the apex of Sedillot’s triangle, a well-defined
anatomical reference point. Using a neonatal sample, this study ascertained the precise positioning of the internal
jugular vein to evaluate its suitability as a central venous catheter insertion site. We also determined the
location of the vein in relation to Sedillot’s triangle.
MATERIALS AND METHODS : Nineteen formalin-fixed neonatal cadavers, encompassing both the left and right sides of
the neck region (totaling 38 sides), were dissected to expose the underlying soft tissues and neurovascular
structures. Thereafter, the three boundaries of Sedillot’s triangle were identified, demarcated, and measured. The
internal jugular vein’s position within Sedillot’s triangle was meticulously recorded, and the diameter of the vein
was measured.
RESULTS : Among the 38 sides examined, only three exhibited fully formed triangles, with most of the samples
featuring a groove instead. When the needle was placed at the apex of Sedillot’s triangle (or within the groove),
the needle consistently accessed the internal jugular vein only 65.8% of the time. In 23.7% of cases, the apex was
observed lateral to the internal jugular vein, and in 10.5% of cases, the apex was positioned medially.
CONCLUSION : The apex of Sedillot’s triangle is an unreliable anatomical landmark for the insertion of central
venous catheters in neonates. Caution should be exercised when employing this landmark in the absence of
ultrasound guidance.
