Airway compromise following contrast extravasation from an external jugular intravenous line

Extravasation of iodinated contrast material (ICM) is an uncommon complication (0.1%-1.2%) following intravenous injection for computed tomography exams and other procedures. Most cases of contrast extravasation are mild and resolve without treatment. Alternative injections sites are occasionally necessary among patients with difficult vascular access and are at increased risk of contrast extravasation and subsequent complications compared to the antecubital fossa. We describe a rare case of airway compromise necessitating intubation following iodinated contrast extravasation from an external jugular IV line. Additional care and monitoring must be performed during and after injection of contrast into these higher-risk vascular access sites.