Presentation
Post operative pleuritic chest pain
Patient Data
Pre PICC scan shows the right sided PICC in the superior vena cava and is appropriate for use.
Bilateral pleural effusion and associated atelectasis. No thromboembolic disease.
The PICC line has been dislodged during the scan and is sitting within the subclavian vein. This is not appropriate for use.
Case Discussion
The radiographer flagged this scan with the radiologist and it was escalated to the team, the PICC line was removed after the exam.
This is an example of PICC dislodgment after pressure injection of iodinated contrast. The current literature suggests that complications such as this are due to the saline flush during the contrast injection causing a sudden change in the viscosity leading to dislodgement.
It is a useful protocol to check the PICC before and afterwards via a low dose axial acquisition (similar to a HRCT) to ensure the PICC is safe to use.
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