Presentation
Premature infant with surfactant deficiency disorder. Request to check lines and exclude NEC.
Patient Data
There is mild rotation at the time of exposure. Hyperinflated lung fields with moderately severe surfactant deficiency disorder. Superadded congenital sepsis is not excluded. Normal cardiomediastinal contour. The ETT is satisfactorily sited, infra-clavicular.
A nasogastric tube (NGT) appears at the gastro-esophageal junction and should be more distally inserted. The umbilical arterial catheter (UAC) is satisfactorily sited at approximately T6 vertebral body level. The umbilical venous catheter (UVC) is intra-hepatically wedged, and retraction and re-siting are indicated. The upper abdominal artifact is secondary to the thermal wrap. There are overlying ECG leads. There is an overlying temperature lead and a rectal temperature probe. A non-specific bowel gas pattern is present.
Case Discussion
The overlying thermal wrap artifact can mimic intraabdominal gaseous lucencies/surgical emphysema / intrahepatic portal venous gas. Care should be made to identify and assess all lines, tubes and catheters in portable x-rays and often the given history or observed findings by the radiographer when imaging these patients assist in the correct image interpretation by the reporting radiologist.
Companion cases: rID 192506 and rID 192511
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