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Age: 10

Sex: Male

Indication: Sepsis, status post central line placement

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Case #40


Findings

  • Right subclavian approach Broviac catheter with tip overlying the right atrium
  • Enteric tube with tip overlying the upper neck
  • No focal airspace opacification, pleural effusion, or pneumothorax
  • Normal size and configuration of the cardiopericardial silhouette


Diagnosis

  • Malpositioned enteric tube

Sample Report

Right subclavian approach Broviac catheter with tip overlying the right atrium. No pneumothorax.

Enteric tube with tip overlying the upper neck. Recommend repositioning.

No focal airspace opacification or pleural effusion.

Normal size and configuration of the cardiopericardial silhouette.


Discussion

  • This is an important corner finding to catch. One approach to finding malpositioned lines is to trace a circle along the periphery of the image and follow any lines you see into the patient
  • Enteric tubes also sometimes coil in the pharynx, which can be a cause for pain
  • The reference listed below provides a good overview of evaluation of lines and tubes in ICU patients


Images

Red arrow: internal portion of the enteric tube overlying the upper neck. Yellow arrows: external portion of the enteric tube.

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