School ager who is having difficulty using their central venous line

Central line injection of a fibrin sheath on a central venous catheter
AP image from a central line injection shows the distal part of the catheter is thicker than the rest of the catheter. Contrast was never seen to exit the tip of the catheter but instead was seen to exit the catheter from a position 2 cm above the tip of the catheter.

The diagnosis was central venous catheter malfunction in the form of a fibrin sheath along the distal catheter.