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Case Reports in Radiology
Volume 2017 (2017), Article ID 1640431, 3 pages
https://doi.org/10.1155/2017/1640431
Case Report

Misplacement of a Port Catheter: A Differentiated View

1Department of Radiation Oncology, University of Halle, Halle (Saale), Germany
2Department of Medical Oncology, St. Georg Hospital Leipzig, Leipzig, Germany
3Department of Radiology, St. Georg Hospital Leipzig, Leipzig, Germany
4Department of Pneumology, Protestant Lung Hospital Berlin, Berlin, Germany

Correspondence should be addressed to Christoph Evers

Received 22 August 2017; Revised 13 November 2017; Accepted 3 December 2017; Published 26 December 2017

Academic Editor: Leo E. H. Lampmann

Copyright © 2017 Christoph Evers et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Clinical radiological controls after the insertion of central venous catheters (CVC) are of high importance. Misplacement of the CVC, outside of large vessels, as described in our first case, occurs in more than 7% of cases and may be associated with life-threatening events. A persistent left-sided superior vena cava (PLSSVC) occurs in 0.3–0.5% of the standard population. In one of the cases a CT scan of the chest showed the catheter in a PLSSVC. Neoadjuvant radiochemotherapy was indicated in a patient with an adenocarcinoma of the oesophagus. Under hospitalised monitoring, full-dose chemotherapy was given. Consequences for the patients arise when the findings are known for future interventions. If a PLSSVC is expected and a CVC is to be inserted, the venous return to the heart should be evaluated first, to preclude a possible backflow to the left atrium. With this constellation, a right-to-left shunt can be expected in in 10% of cases. Affected patients face a high risk of developing cardioembolic events.