Presentation
Patient presented with new onset confusion for investigation.
Patient Data
Linear foreign body over cardiac silhouette in region of the left pulmonary vasculature. Consistent with fractured peripherally inserted central catheter tubing
Mild left lower lobe air space opacity without confluent consolidation potentially representing infection.
Case Discussion
Incidental finding of fractured peripherally inserted central catheter (PICC) on chest x-ray ordered as part of delirium screen. It was clarified in history that the PICC was inserted three decades ago during ICU admission and fractured at that time. It has since been conservatively managed with monitoring with no attempt made at retrieval. The patient reports nil complications since.
The Incidence of PICC fracture has been reported as ranging from 0.2% to 9.7% 1. Fractured PICCs are typically removed as they carry a risk of complications including vascular perforation, pulmonary embolism, cardiac tamponade and arrhythmias 2. Given the chronicity of the PICC fracture and the stability of symptoms since, it was determined to be unlikely to be contributing to the current presentation, with a plan for no further intervention at this point.
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