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Malpositioned internal jugular central venous catheter

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Post colectomy. ICU admission.

Patient Data

Age: 80 years
Gender: Male

Right internal jugular CVC is kinked back on itself and the tip is projected cranially. Free gas under the right hemidiaphragm in keeping with recent abdominal surgery. 

Zoomed image better shows the kinked CVC with the tip facing cranially.

Case Discussion

Careful evaluation of all lines is required to avoid missing a malposition or complication - this is a tricky case with the kinked CVC tip not well seen without zooming on the region. 

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