I received an interesting CT Chest from one of our EM residents in a patient with SVC (Superior Vena Cava) syndrome. The patient had a PORT in place with clot around the PORT occluding the SVC. This is an interesting case with a couple common and a couple rare findings:
This is a complicated CT showing multiple findings:
A: Good example of a right pleural effusion, large, seen on CT. The patient also has a left sided effusion.
B: Cross-section of the SVC showing the PORT cath and clot occluding the vessel
C: Longitudal view of the SVC, again with PORT and clot
D: The patient had the contrast injected from a right arm peripheral IV. There are extensive collaterals in the arm and right chest with blood flow returning through these collaterals rather than traditional axillary vein to SVC.
E: This view shows one of the collaterals actually connecting to the pulmonary vein.
Author: Russell Jones, MD
Image Contributor: Julie Phan, MD