External devices and chest x-ray in critically ill patients: a pictorial review.

Congress:

ECR 2011

Poster Number:

C-2290

Type:

Educational Exhibit

Keywords:

Foreign bodies, Diagnostic procedure, Conventional radiography, Thorax, Mediastinum, Lung

Authors:

J. Arias Fernandez, L. García Del Barrio, M. Ferreira Caramalho, P. Slon, J. Etxano Cantera; Pamplona/ES

DOI:

10.1594/ecr2011/C-2290

DOI-Link:

https://dx.doi.org/10.1594/ecr2011/C-2290

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Learning objectives

To show radiographic appearance of external devices in chest x-ray of patients in intensive care units (ICU). To describe complications of external devices and how to detect them on chest x-ray

Background

The portable chest X-ray (PCXR) is one of the most commonly requested radiographic examinations in the critically ill patient. It’s readily available, easy and quick to perform at the patient’s bedside, and much less expensive than any other imaging modality. The PCXR plays a key role in aiding diagnosis, in monitoring evolution and in evaluating response to therapy. The quality of the PCXR can be highly variable, ranging from good to uninterpretable. There are two groups of limitations to obtaining quality PCXR: The first group...

Imaging findings OR Procedure details

External devices [3,4] Enteric Tubes Function and position: The ideal position varies between the gastric antrum or duodenum when the enteric tube is used exclusively for feeding and within the stomach when it is used for suction or medication administration (figure 1). Complications: - When it is located in digestive tube, it may cause aspiration, when the tip is located in distal esophagus and reflux occurs or when the patient has gastric hernia and the tip remains in the herniated stomach (figure 2). It sometimes...

Conclusion

Portable chest x-ray is the most common radiologic exam in intensive care units and critically ill patients. External devices are very common in such patients, and radiologists must know the radiological appearance of external devices and their complications, to help physicians in the management of these patients in a multidisciplinary approach to critically ill patients.

Personal Information

References

1. Trotman-Dickenson B. Radiology in the intensive care unit (part I). J Intensive Care Med. 2003;18:198-210. 2. Taljanovic MS, Hunter TB, O'Brien MJ, Schwartz SA. Gallery of medical devices: Part 2: Devices of the head, neck, spine, chest, and abdomen. Radiographics. 2005 ;25:1119-32. 3. Rubinowitz AN, Siegel MD, Tocino I. Thoracic imaging in the ICU. Crit Care Clin. 2007;23:539-73. 4. Hill JR, Horner PE, Primack SL. ICU imaging. Clin Chest Med. 2008;29:59,76, vi.