LAUSR

After the routine protocol (consent, asepsis, etc.), a linear probe covered with a sterile sheath was placed on the right side of the neck to identify the internal jugular vein (IJV). Three hypoechoic circular structures were visualised, out of which two were easily compressible with the probe (jugular veins), and the third was pulsating. The carotid artery was most medial. After local anaesthesia was administered using a 26 G long needle, and when the central line puncture needle was about to be introduced using the ultrasonography guide, it was noted that the lateral hypoechoic circular shadow moved medially, but was easily compressible. It was suspected to be the colonic shadow mimicking the IJV. Needle insertion was avoided, and expert help and opinion called for. It was confirmed that the hypoechoic compressible shadow was indeed the colonic shadow. The IJV was compressed antero-laterally and was confirmed by colour Doppler [Figures 1 and 2]. Successful cannulation of the right IJV was completed without any complications subsequently.