migration of the catheter tip out of the vessel into the mediastinum

Our DDX For

this Week IsCXR from 1 month before (above) shows the tip of the catheter in a left-sided superior vena cava. Scout image from a line study (below left) shows the tip of the catheter has apparently migrated out of the left-sided superior vena cava. Injection of the catheter (below right) shows contrast extravasating into the mediastinum.The diagnosis was migration of the catheter tip out of the vessel into the mediastinum.