Thursday, September 8, 2016


A 70 year old patient comes in with septic shock. She is febrile, tachycardic, hypotensive, tachypneic, and hypoxemic. Her labs show a leukocytosis, elevated lactate, and elevated procalcitonin. Chest X-ray shows a right lower lung focal opacity. She is fluid resuscitated with 5 liters of crystalloid but still has refractory hypotension. The emergency medicine intern puts in a right internal jugular central venous catheter to start norepinephrine. Later, a KUB is taken which is shown above.

Challenge: What complication happened here?

Image shown under Fair Use.

1 comment:

Craig Chen said...


The KUB shows a guidewire used in central line placement. Wire embolism is a rare complication that occurs when control of the guidewire is lost.