Sonographic Appearance of a Retained Tunneled Catheter Cuff Causing a Foreign Body Reaction

Sonography is useful in imaging and diagnosing occult soft tissue foreign bodies, especially those that are ractiolucent. The sonographic features of frequently encountered foreign bodies, including metal, glass, gravel, wood, and plastic, have been described in the literature. Foreign bodies from retained surgical instruments or medical devices are often easily identified on radiographs because they are usually radiopaque or contain radiopaque markers. Similarly, vascular catheters are radiopaque; however, the cuffs found with tunneled catheters are generally radiolucent. Tunneled vascular catheters with cuffs are commonly used in both hospital and outpatient settings. A long-term complication of these is cuff retention when removed by manual traction, although this is rarely of clinical importance. Despite the fact that cuff removal is advocated by catheter manufacturers, they are commonly left in place when retained. We present the sonographic findings with histopathologic correlation of a retained cuff causing a foreign body giant cell reaction 11 months after the catheter had been initially removed. in this case, a hypoechoic halo of granulation tissue was seen surrounding an echogenic shadowing catheter cuff.