Demographics:
66 years old, Female
Indication:
Line placement
Findings
- Left internal jugular central venous catheter with tip overlying the aortic arch
- Right internal jugular port catheter with tip overlying the superior cavoatrial junction
- Left subclavian Swan-Ganz catheter with tip overlying the right pulmonary artery
- Endotracheal tube tip projects 2 cm above the carina
- NG/OG tube courses beyond the inferior border of the image with tip overlying the gastric fundus
- Low lung volumes with bilateral interstitial thickening and hazy bibasilar opacities
- Layering bilateral pleural effusions
- No pneumothorax
- Enlarged cardiopericardial silhouette
Diagnosis
Malpositioned central venous catheter
Sample Report
Left internal jugular central venous catheter with tip overlying the aortic arch. While this could represent venous placement, arterial placement cannot be excluded on this image. Recommend correlation with blood gas analysis.
The remainder of the indwelling support apparatus projects in its expected position.
Cardiomegaly with pulmonary edema and layering bilateral pleural effusions.
Discussion