Presentation
Post colectomy. ICU admission.
Patient Data
Age: 80 years
Gender: Male
From the case:
Malpositioned internal jugular central venous catheter
Frontal

Right internal jugular CVC is kinked back on itself and the tip is projected cranially. Free gas under the right hemidiaphragm in keeping with recent abdominal surgery.

Zoomed image better shows the kinked CVC with the tip facing cranially.
Case Discussion
Careful evaluation of all lines is required to avoid missing a malposition or complication - this is a tricky case with the kinked CVC tip not well seen without zooming on the region.