CT Contrast Injection Leak Causes Patient Compartment Syndrome

Case Overview

This case involves a 28-year-old male patient who underwent an IV infiltration at a radiology clinic prior to having imaging. In the process of having a CT scan with contrast, the contrast extravasated into the patient’s left hand. The patient noted severe swelling and pain and notified the technologist. Once the technologist was notified, the patient was sent to the emergency room. The patient was then urgently sent to the operating room where he had a fasciotomy due to compartment syndrome in the left hand with a carpal tunnel release. Following the surgery, the patient was put on a 5-pound lift, push, and pull restriction for his left hand.

Questions to the Radiology expert and their responses

How often do you place IVs in patients prior to the performance of imaging studies?

IV's are used commonly in CT to provide enhancement of infections, lesion/tumors, and highlight structures, such as arteries and veins and bleeds. Approximately 25-35% of cases require contrast injections.

What factors contribute to contrast extravasation?

Many variables can lead to contrast extravasation including patients habitus, injection site, etc.

About the expert

This expert has almost thirty years of experience in the field of radiology technology. He earned his BS in radiologic science from the Florida Hospital College of Health Science, as well as his MA in hospital administration from Colorado State University. He is a certified radiology administrator and is registered as a radiographer and one who performs CT Scanning. He was formerly a diagnostics technologist and CT technologist at Fairfax Hospital, a diagnostics supervisor at Inova Mount Vernon Hospital, and a clinical operations manager of the radiology department at Inova Healthplex. He is currently a radiologic technologist at a major hospital in DC.