This 42-year old male was receiving TPN via a PICC line following recent abdominal surgery for an appendiceal abscess. A CTPA was requested to investigate right pleuritic chest pain:
Questions
Q1. What does the CT scan demonstrate?
There is a PICC line which ends up in the mediastinum (this is a bad place to infuse TPN).
There is also a liver abscess.
This CT demonstrates that all pleuritic chest pain does not come from above the diaphragm and that a pulmonary embolism is not the only cause of pleuritic chest pain to consider in a post-operative patient.
Q2. What are the complications of PICC lines?
There are lots of them:
- malposition (including into the mediastinum!)
- catheter fracture
- catheter knots
- catheter blockage
- infection
- arrhythmia
- thrombosis
- thrombophlebitis
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