School ager with catheter that infuses but does not draw back

Line study of a central venous catheter tip that has migrated out of the vessel
CXR from 1 month before (above) shows the tip of the catheter in a left-sided superior vena cava. Scout image from a line study (below left) shows the tip of the catheter has apparently migrated out of the left-sided superior vena cava. Injection of the catheter (below right) shows contrast extravasating into the mediastinum.

The diagnosis was migration of the catheter tip out of the vessel into the mediastinum.