Pediatric line placements

Case contributed by Morlie L Wang
Diagnosis almost certain

Presentation

Less than 24 hours old. Shortness of breath. Gestational age 26 weeks.

Patient Data

Gender: Male
x-ray

Patient is rotated to the right. The UVC tip projects over the left atrium, passing through the foramen ovale and should be pulled bak 3 cm. UAC projects at T10 and should be advanced by 1.0 cm. ET tube projects at the carina and should be withdrawn approximately 5 mm. The NG tube projects over the stomach. Cardiothymic silhouette appears. normal. The lungs are well-expanded with bilateral diffuse interstitial opacities suggestive of interstitial edema vs. multifocal atelectasis upon respiratory distress syndrome. Non-obstructing bowel gas pattern. No penumoperitoneum. Moderate gaseous distention of the stomach.

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