Malpositioned PICC line

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Sepsis. PICC line inserted for vascular access.

Patient Data

Age: 65 years
Gender: Male
x-ray

Right sided PICC line, the tip of which is off the superior limit of the film having entered the right internal jugular vein and coursing cranially.

Lungs clear. No pneumothorax.

Case Discussion

The positions of lines and tubes should be reviewed first on interpreting the chest x-ray.

This PICC line tip has traversed into the internal jugular vein rather than its desired site in the SVC.

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