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Retained guidewire

Case contributed by Stefan Tigges
Diagnosis certain

Presentation

Shortness of breath.

Patient Data

Age: 70 years.
Gender: Male
x-ray

Mild pulmonary edema. Retained AICD fragment left brachiocephalic vein/SVC, retained metal fragment left pleural space, no pneumothorax or pleural effusion.

x-ray

Worsening edema, new left lower lobe opacity, likely atelectasis. New retained guidewire coursing up the IVC, into the right atrium and back down the IVC with its tip in a hepatic vein.

x-ray

Right femoral vein sheath extends into the external iliac vein with a guidewire extending superiorly into the IVC as shown on the chest X-ray.

ct

Small bilateral pleural effusions with passive atelectasis adjacent lung. Mild pulmonary edema. Retained AICD fragment left brachiocephalic vein/SVC, retained metal fragment left pleural space, no pneumothorax or pleural effusion. Endotracheal tube appropriately positioned. Retained guidewire coursing up the IVC, into the right atrium and back down the IVC with its tip in a hepatic vein.

Case Discussion

This is a characteristic appearance for a retained guidewire.

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