Fibrin sheath

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Chest port for chemotherapy. Able to flush but not aspirate.

Patient Data

Age: 55 years
Gender: Female
Fluoroscopy

Left internal jugular chest port with the tubing intact. Tip is in the region of the superior cavoatrial junction.

Hand injection of iodinated contrast demonstrates retrograde flow in keeping with a fibrin sheath.

Case Discussion

Fibrin sheaths are a relatively common occurrence with long-term central venous catheters, and present with a classic "flush but no aspirate" problem.

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