CTICasesCentral Catheter Coursing into Anomalous Pulmonary Venous Drainage
Imaging findings
A trauma patient had a hemodialysis catheter that appeared to project into the lung on radiograph without hemothorax or pneumothorax. CT follows the catheter from the superior vena cava into a channel that continues peripherally into the lung, with a branching soft-tissue vascular structure and no surrounding tract or pneumothorax on lung windows. Vessels draining the middle lobe and part of the lower lobe connect to the SVC, confirmed on an old thick-section trauma CT showing anomalous pulmonary venous drainage.
Key takeaways
A catheter that appears to course out into the lung without an associated hemothorax, pneumothorax, or parenchymal tract should raise suspicion for placement within an anomalous pulmonary vein rather than a traumatic malposition. Partial anomalous pulmonary venous drainage can provide a channel large enough to accommodate a catheter, and recognizing the anomalous venous anatomy explained the benign appearance and allowed uneventful removal.
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