Dear colleagues,
Edgar; one of our young residents at Hospital Dr. Peset showed me this case:
62 year old woman.
Portable control after catheter placement.
Where is the catheter?:
1- In the pleura
2- In an artery
3- In a vein
4- In a bronchus
Check the image below, leave your thoughts in the comments section and come back on Friday for the answer.
Click here for the answer
CT: axial and coronal MIP projections. The jugular catheter enters the anomalous vessel through the innominate vein. The clue in the chest radiograph is the continuation of the catheter with the neck veins (Innominate, Jugular).
Diagnosis: Partial anomalous pulmonary venous drainage
Teaching point: Partial anomalous venous drainages are not frequent, the most common being the right lower lobe (scimitar). They are hemodynamically left to right shunts, and often asymptomatic but could lead to confusion especially when placing venous catheters or pacemakers.
