Pediatric Radiology

, Volume 38, Issue 3, pp 331–335 | Cite as

The bowed catheter sign: a risk for pericardial tamponade

  • Richard TowbinEmail author
Case Report


The use of a central venous catheter (CVC) has become commonplace in the care of children with a wide variety of medical and surgical problems. Complications resulting from the insertion of these catheters are well recognized and can be life-threatening. When a temporary CVC or other catheter is inserted into the central venous system it is secured to the skin with a combination of sutures and sterile dressing. This fixes the catheter in place and does not allow it to retract, thereby putting pressure on the right atrial wall via the catheter tip if it is too long. The probability of wall penetration is increased if a catheter or device is tapered at the point of contact. The purpose of this case report is to present the bowed catheter sign and to review the anatomy of the cavotricuspid isthmus, a possible predisposing factor to cardiac perforation and tamponade.


Central venous catheter Bowed catheter sign Central venous catheter complication 



The author is grateful to Janet Towbin for her computer skills and Pat Thomas for her medical illustrations.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Department of RadiologyPhoenix Children’s HospitalPhoenixUSA

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