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Caval misplaced wire

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Recurrent epigastric pain, history of pancreatitis. Elevated lipase.

Patient Data

Age: 50-55 years
Gender: Female
ct
  1. Minor pancreatitis, improved from the previous CT last month. No pseudocyst or collection.
  2. Metallic wire within the venous system extending from a left gluteal vein, through the left internal iliac, left external iliac, IVC, extending through the right atrium into the SVC. The superior tip is not visualized.
x-ray

A long wire projected within the cavae and right atrium. The superior tip is cureve suggesting in was inserted from below (femoral line insertion) and is projected within the lower jugular vein. The lower tip is not visualized.

Case Discussion

The patient had a history of recurrent pancreatitis and had a previous ICU admission earlier for complicated pancreatitis during which time they had a left femoral venous catheter inserted.

The wire was snared by the interventional radiologist using a femoral approach as the preferred jugular approach was not available due to jugular thrombosis.

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