Swan Ganz catheter misplacement with pulmonary artery rupture
Diagnosis certain
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Status
changed from pending review to published (public).
Published At
was set to
.
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Findings
was changed:
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distalDistal end of the Swan Ganz catheter in the middle lobe
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diffuse.Diffuse
alveolar pattern in the right basal and middle lobes. Blunting of the left costophrenic angle, pacemaker, and sternal strapping
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Caption
was removed:
Findings
was changed:
- distal end of the Swan Ganz catheter in the middle lobe, medial segment, with intraparenchematous trajectory, perforating the middle lobe artery (best seen on the non-contrast CT)
- diffuse alveolar pattern in the right basal and middle lobes with acute contrast extravasation visible on the contrast-enhanced CT, compatible with active hemorrhage
1,2 - bilateral pleural effusion
- peacemaker and sternal post-surgery changes
- 3D heart reconstruction shows the distal end of the catheter in white, perforating the middle lobe artery
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Description
was changed:
Patient presents 250 mlmL of hemoptysis 20 minutes after the Rxdiagnosis is made, and an urgent CT angiography is requested.
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Answer
was changed:
The blood coughing likely originates from a rupture in the pulmonary artery when the Swan Ganz was reinflated.
The alveolar pattern first seen on the Xx-ray is now most likely an alveolar hemorrhage.
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