Submitted by Dr Tang Kam Shing on 5 February 2009
ICU, Tuen Mun Hospital
During a routine insertion of RIJ CVC in a COPD patient on mechanical ventilation, multiple attempts have failed by landmark technique.
An ultrasound of the RIJ was therefore determined to look for abnormal anatomy. The following image was obtained. Do you think it is thrombosed or not?
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Answer: It certainly looked like that there is a thrombus in the RIJ. A radiologist is consulted and he thinks this is called “spontaneous echo contrast” in great veins, which is of no clinical importance. A compression is done and showed complete collapsibility. A CVC was subsequently inserted