Malpositioned umbilical catheters

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Preterm (27 weeks) with respiratory distress.

Patient Data

Age: Newborn
Gender: Male

Umbilical venous catheter tip projecting over the left heart, likely after passing through a patent foramen ovale. Umbilical arterial catheter is also seen in position with its tip projecting over 4th thoracic vertebra. Appropriately positioned feeding tube. Changes of RDS noted in both lungs. No pneumothorax is seen.  

Umbilical catheters had been withdrawn/re-adjusted; now the tip of UVC is seen lying at 7th and the tip of UAC is seen lying at 8th thoracic vertebral body level.

Echocardiogram report

Photo

Echocardiography shows a patent foramen ovale with left to right shunt.

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