Transposition of the great indwelling pleural catheter

A 70-year-old male with sarcomatoid renal carcinoma presented to his general practitioner with worsening breathlessness. He was referred to the radiology department for a radiograph of the chest, which showed recurrence of a known right malignant pleural effusion (MPE) (figure 1A). After 4 days, he underwent an uncomplicated right indwelling pleural catheter (IPC) insertion and drainage. The postprocedure radiograph of the chest (figure 1B) showed improved appearances of the right MPE and a new small left pleural effusion that had been seen on the preprocedure ultrasound and likely progressed since his presenting radiograph. The radiographer’s report raised concerns that the right IPC tip …