CASE
A 62-year-old woman presented to the emergency department complaining of abdominal pain. After undergoing CT, she was diagnosed with a perforated duodenal ulcer. An urgent laparoscopic Graham patch procedure was performed to repair the defect.
The patient's initial postoperative course was uneventful. However, melena associated with acute blood-loss anemia on postoperative day 4 prompted a tagged RBC scan, which identified ileal hemorrhage. The patient was transferred to the ICU for plasma volume expansion guided by central venous pressure monitoring. A triple-lumen catheter (TLC) was placed using the left subclavian position. The subclavian vein was accessed on the first attempt, and catheter insertion, utilizing the Seldinger technique, was accomplished without complication. A portable anteroposterior chest radiograph was obtained to confirm placement (Figure 1). What did the radiograph show?
