massive pulmonary embolism caused by thrombosis formed on a central catheter in a child a case is reported of a 9yearold girl admitted with a subarachnoid haemorrhage her neurological recovery was favourable after the embolization of a cerebral arteriovenous malformation she stayed in icu with mechanical ventilation because of a bacterial pneumonia and a postextubation laryngeal oedema she required insertion of a polyurethane subclavian catheter as a peripheral venous access was not available five days later the child suffered a sudden respiratory distress without changes of the electrocardiogram and the chest xray the diagnosis of pulmonary embolism was suspected because of the presence of the central venous catheter a catheter dysfunction and a superior vena cava syndrome a catheter tip thrombus was shown by angiography as well as a thrombus in the pulmonary artery a 90 obstruction of the proximal valvular tree of the right lung a 10 to 15 distal obstruction in the left lung a complete obstruction of the superior vena cava scv the thrombolytic therapy was contraindicated in this case because of the neurological pathology heparin was given by continuous intravenous infusion when heparin concentration was at an appropriate level the catheter was removed its microbiological culture remained negative the next day another angiography showed a partial permeability of the svc and a better right pulmonary perfusion during this procedure the haemodynamic assessment showed only moderate abnormalities therefore the surgical treatment was not indicated and the heparin continued the child recovered gradually with a normalization of the lung scintigraphy