Day: November 3, 2023

Preschooler with a central venous catheter that infuses but does not draw back

Radiology case of fibrin sheath
Image from a central line study after the injection of a small amount of contrast (left) shows that the distal portion of the catheter is thicker in diameter than the proximal portion of the catheter. Image obtained after the injection of a small amount of additional contrast (right) shows contrast flowing not from the tip of the catheter but rather contrast flowing from the right side of the catheter just above where the catheter thickening begins in the left image.

The diagnosis was central venous catheter malfunction due to the presence of a fibrin sheath.