Following routine coronary artery bypass grafting, a radiopaque shadow was seen in the left upper zone on 2 separate chest radiographs taken 3 days apart (Figure 1). This was constant in location and was therefore thought to be a foreign body left inadvertently in the thorax. The likeliest possibility was a soft bulldog clamp seen end-on, applied to a saphenous vein graft to the circumflex. The next steps were to organize a computed tomography scan and perhaps reexplore the patient to retrieve the retained foreign body. However, discussions with radiologists revealed that this was in fact an artifact due to a damaged cassette housing the film. It was sheer coincidence that the patient had the same cassette during both chest radiographs. Absence of the shadow was confirmed by repeating the radiograph with a different cassette (Figure 2). Abnormal shadows suggesting retained foreign bodies can be misleading and have medicolegal consequences as well. Discussion with the radiologist is helpful not only to make a proper diagnosis but also to avoid inappropriate investigations.
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