Newborn with abnormal prenatal echocardiogram after PICC placement

AXR of lower extremity peripherally inserted central catheter / PICC in a left-sided inferior vena cava in a patient with situs inversus
AXR AP shows a left lower extremity PICC and a right femoral venous catheter both of whose tips project over a left-sided inferior vena cava. An umbilical venous catheter tip projects over the ductus venosus. An umbilical arterial catheter tip projects at the level of T9. Nasogastric tube tip projects over the stomach in the right upper quadrant. Feeding tube tip projects transpylorically over the duodenal bulb. The cardiac apex is in the right chest.

The diagnosis was appropriate position of the PICC and low malposition of the umbilical venous catheter in a patient with situs inversus.

Premature newborn with hypoplastic abdominal wall musculature after PICC placement

AXR of peripherally inserted central catheter / PICC in the renal vein in a patient with gastroschisis
AXR AP and lateral shows a right lower extremity PICC coursing across the midline with its tip projecting over the left renal vein. The abdomen appears to be bulging and protruberant in both medial-lateral and anterior-posterior dimensions. The tip of the bladder catheter projects high within the pelvis within a dilated bladder

The diagnosis was low malposition of the PICC in a patient with Prune Belly Syndrome.

Premature newborn after PICC placement

AXR of lower extremity peripherally inserted central catheter / PICC in the iliac vein
AXR AP shows a left lower extremity PICC which courses across the midline and down the right common iliac vein. The tip of the umbilical venous catheter projects over the umbilical vein. The tip of the umbilical arterial catheter projects at T6.

The diagnosis was low malposition of the PICC and low malposition of the umbilical venous catheter and appropriate position of the umbilical arterial catheter.

Premature newborn after PICC placement

CXR of peripherally inserted central catheter / PICC changing in position as arms move up and down
CXR AP with the left arm down (left) shows the tip of the left upper extremity PICC to project deep within the right atrium. CXR AP with the left arm up (right) obtained later the same day shows the tip of the PICC to have moved back into the superior vena cava. There is ground glass opacity throughout the lungs.

The diagnosis was change in position of the upper extremity PICC tip due to change in arm position in a patient with respiratory distress syndrome.

Infant status post PICC placement 1 month ago with an incidental calcification on their AXR

CXR and US of inferior vena cava thrombus caused by peripherally inserted central catheter / PICC
AXR AP shows the tip of a lower extremity PICC projecting within the inferior vena cava with its tip at T11 with a long tubular calcification extending from the PICC tip to the level of the right atrium. Transverse US of the liver at the level of the hepatic veins draining into the inferior vena cava shows a round echogenic lesion with posterior shadowing within the inferior vena cava that extended from the tip of the PICC to the cavo-atrial junction.

The diagnosis was chronic thrombus of the inferior vena cava secondary to PICC placement.