Portacath migration into the pleural space

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Undergoing chemotherapy. Portacath inserted weeks ago without complication, now not flushing. Right sided pleuritic chest pain.

Patient Data

Age: 50
Gender: Female

Injection of radiographic...

Fluoroscopy

Injection of radiographic contrast into portacath under fluoroscopic control

No blood aspirated.  Resistance met with attempted contrast injection.  Contrast passes via the catheter and enters an unknown (non-vascular) space

Post portacath C+ injection

ct

Tip of the catheter is in the right pleural space anteriorly and the injected contrast (arrows) has entered the right pleural space medially associated with a small pleural effusion.

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