Newborn with respiratory distress on ECMO

CXR of malposition ECMO catheter in patient with congenital diaphragmatic hernia — CXR shows normal position of the arterial catheter tip in the aortic arch and abnormal position of the venous catheter tip (represented by a radio-opaque point) in the superior vena cava. Further advancement of the tip into the right atrium is necessary. Multiple cystic structures are present in the left hemithorax. The lungs are densely opacified.

The diagnosis was extracorporeal membrane oxygenation catheter malposition with the venous catheter tip in the superior vena cava in a patient with left sided congenital diaphragmatic hernia containing stomach and loops of bowel.