CTICasesFlipped Subcutaneous Venous Port
Imaging findings
Chest radiograph shows a subcutaneous venous access port that has flipped 180 degrees. The port's radiopaque 'CT' letters, which should normally read left-to-right, are visualized as a mirror image, indicating that the base of the port is facing anteriorly.
Key takeaways
Flipping of a venous access port (sometimes called 'Twiddler's syndrome') is a mechanical complication where the port reservoir rotates in its subcutaneous pocket. Radiologists must check the orientation of the port letters (such as 'CT' on power-injectable ports); a mirrored appearance indicates the port has flipped, preventing safe needle access and risking subcutaneous extravasation.
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