[Abnormal x-ray finding after central venous catheterization].

Area of Science:

• Medical Imaging
• Interventional Radiology
• Anesthesiology

Background:

• Central venous catheter (CVC) placement is essential for patient management during complex surgeries.
• Potential complications include catheter fracture, guide wire loss, and embolization, necessitating careful monitoring.
• Large bore CVCs are used in specific procedures like thoracic spine surgery.

Observation:

• An abnormal finding was noted on a postoperative X-ray following thoracic spine surgery in a 32-year-old patient.
• Initial suspicion focused on a retained guide wire fragment, a known CVC complication.
• The anesthesiologist who inserted the catheter confirmed the guide wire was intact.

Findings:

• Further investigation using additional X-ray and CT scans of an identical catheter was performed.
• The abnormal radiographic finding was definitively identified as polyurethane pins integrated within the CVC.
• These pins, a component of the catheter's design, mimicked a retained foreign body.

Implications:

• Radiologists and clinicians must be aware of non-pathological CVC components that can mimic complications.
• Accurate interpretation of postoperative imaging is crucial to avoid unnecessary interventions.
• Understanding device composition can prevent misdiagnosis of guide wire embolization or catheter fracture.