PMC6815971_01
Chest X-ray showing the PICC line in the subclavian vein. Also shown is the R sided chest drain in situ.
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fig2
PICC tip placement was confirmed with a chest X-ray and total parenteral nutrition was commenced (Figure 2). Patient developed mild voice changes and shortness of breath 36 hours later.
(a) Sagittal, (b) coronal, and (c) horizontal: computerised tomography slice demonstrating extensive retropharyngeal emphysema and pneumo-mediastinum.
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fig3
Tomography scan of neck, chest and abdomen performed on day 12 following initial transplantation demonstrated mediastinal collection, mediastinal emphysema as well as extensive retro-pharyngeal air tracking (Figures 3(a)-3(c)). The CT chest and neck vessel angiography report noted that PICC line was not convincingly intravascular and appeared to be outside the great vessels (Figure 4).
(a) coronal slice and (b) horizontal slice. Arrows demonstrating computerised tomographic angiography.
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fig4
Tomography scan of neck, chest and abdomen performed on day 12 following initial transplantation demonstrated mediastinal collection, mediastinal emphysema as well as extensive retro-pharyngeal air tracking (Figures 3(a)-3(c)). The CT chest and neck vessel angiography report noted that PICC line was not convincingly intravascular and appeared to be outside the great vessels (Figure 4).