Bilateral PICCs

Case contributed by Dr Daniel J Bell

Presentation

ICU patient. To confirm position of left-side PICC.

Patient Data

Age: 45 years
X-ray

Left-sided PICC in reasonable position.  Right-sided PICC as previously.  Right dual-lumen vascular catheter, ET tube and nasogastric tube in good position. Lungs clear. Evidence of previous left upper quadrant surgery.

Case Discussion

Bilateral PICCs (peripherally-inserted central catheters) are unusual, but maybe required when there are either issues with central venous access or the central venous catheter(s) placed are reserved for a critical function. In this patient there is a dual-lumen catheter inserted via the right internal jugular vein which is solely for the patient's haemodialysis.

Unusually in this case, the entirety of the PICC can be seen on the left, usually the humerus is not included on a chest radiograph, but because the x-ray examination has been performed as a mobile on the critical care unit, optimal positioning has not been possible. The position of the proximal end of the PICC suggests insertion into the basilic vein.

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Case information

rID: 66163
Published: 8th Feb 2019
Last edited: 2nd Mar 2019
Inclusion in quiz mode: Included
Institution: North Middlesex University Hospital

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