CTICasesAzygos Port Catheter Transpleural Malposition
Imaging findings
CT chest shows a surgically implanted venous port catheter with the reservoir in the chest wall, but with the catheter taking an atypical course: it enters the pleural space, tracks through the major fissure of the lung, and then penetrates and terminates within the arch of the azygos vein, with surgical clips visible at the insertion site.
Key takeaways
Central venous port catheters are typically placed percutaneously via the internal jugular or subclavian veins. However, in patients with severe venous access issues or anatomical variations, atypical surgical approaches can be utilized. Recognizing this unusual transpleural/fissural course to the azygos vein is important to prevent misinterpreting it as an accidental pleural perforation.
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