WWWTP#7 Answer

May 24, 2013


Apparently the patient had been admitted to another hospital with sepsis recently.  On the Chest Xray you can see a thin metallic wire extending from the superior vena cava to the left hemidiaphragm area.  This was initially missed on the Xray and found on further imaging.  The patient had an abdominal CT (she had right lower quadrant pain) and with mediastinal windows the metallic object can be seen:

Guidwire chest CT 1Guidewire chest CT 2

The patient had a retained guidewire from a previously placed right IJ catheter.  This was a very weird incidental finding!  She was eventually sent to interventional radiology where it was removed.  Unfortunately it had nothing to do with her abdominal pain.

Author:  Russell Jones, MD

Image Contributor:  Aaron Hougham, MD

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EMREMS: Radiology in Emergency Medicine

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