Premature newborn after umbilical venous catheter placement

AXR of umbilical venous catheter perforation out of vein
Supine AXR (upper left) shows the umbilical venous catheter tip coursing to the left of midline. Cross-table lateral AXR (upper right) shows the umbilical venous catheter tip projecting over the anterior abdomen with air bubbles along the catheter tract. CXR taken after placement of a second umbilical venous catheter (below) shows the new umbilical venous catheter tip in the right or left atrium and the first umbilical venous catheter tip projecting over the left upper quadrant over no known vein with air bubbles along its tract. US subsequently showed the tip of the first umbilical venous catheter was in the subcutaneous tissues of the anterior abdominal wall.

The diagnosis was perforation of the first umbilical venous catheter out of the vein lumen and high malposition of the second umbilical venous catheter in the atrium.