Chest Radiograph – Tubes, Lines, and Drains

History: 65 year old male status post coronary artery bypass graft surgery.

Frontal chest radiograph reveals multiple lines and tubes (see below for explanation). Multiple median sternotomy wires are present and surgical clips are seen projecting over the mediastinum.

The upward pointing arrow on the patient’s right labels a Swan-Ganz catheter coursing through the right internal jugular vein and ending in the right pulmonary artery. The downward pointing arrow on the patient’s left labels a mediastinal drain. The leftward pointing arrow over the patient’s trachea indicates the tip of the endotracheal tube. The rightward pointing arrow over the patient’s upper abdomen indicates the side-hole of an nasogastric tube. A portion of the nasogastric tube external to the patient and multiple telemetry wires also overlie the chest. While the mediastinal silhouette appears widened, this is a normal expected finding after CABG. Additionally, the perihilar ground glass and reticular opacities indicative of mild interstitial pulmonary edema is commonly seen after CABG.