umbilical venous catheters

Newborn after
umbilical arterial catheter placementAXR supine shows an umbilical arterial catheter that loops back upon itself in the aorta and whose tip projects in the right iliac artery at S3. The umbilical venous catheter tip projects at the junction of the inferior vena cava and the right atrium.The diagnosis was low malposition of the umbilical arterial catheter and appropriate position of the umbilical venous catheter.
pediatricimaging.org • CC-by-nc-sa 4.0
Umbilical
venous catheters • Umbilical vein catheter in left portal vein - Ganzer Fall bei Radiopaedia
Jones J, Umbilical vein catheter in left portal vein. Case study, Radiopaedia.org (Accessed on 17 Jul 2024) https://doi.org/10.53347/rID-24122 • CC by-nc-sa 3.0 (modified)
Hepatic
abscess • Umbilical venous catheter-related hepatic fluid collection (TPNoma) and abscess formation - Ganzer Fall bei Radiopaedia
Ranchod A, Umbilical venous catheter-related hepatic fluid collection (TPNoma) and abscess formation. Case study, Radiopaedia.org (Accessed on 03 May 2024) https://doi.org/10.53347/rID-177229 • CC by-nc-sa 3.0 (modified)
Umbilical
venous catheters • Umbilical vein catheter in the right portal vein - Ganzer Fall bei Radiopaedia
Hacking C, Umbilical vein catheter in the right portal vein. Case study, Radiopaedia.org (Accessed on 17 Jul 2024) https://doi.org/10.53347/rID-63033 • CC by-nc-sa 3.0 (modified)
Newborn with
hypoxic ischemic encephalopathy status post umbilical arterial and umbilical venous catheter placementCXR AP shows the tip of the umbilical arterial catheter to be in the celiac artery. The tip of the umbilical venous catheter is at the junction of the inferior vena cava and right atrium. Esophageal temperature probe tip projects over the mid-esophagus. The patient is lying upon a cooling blanket.The diagnosis was low malposition of the umbilical arterial catheter and correct position of the umbilical venous catheter in a patient with hypoxic ischemic encephalopathy.
pediatricimaging.org • CC-by-nc-sa 4.0
Newborn with
complex congenital heart disease. Sagittal CT with contrast of the chest shows the umbilical venous catheter to course through the umbilical vein into the liver to the left portal vein to the ductus venosus to the left hepatic vein to the inferior vena cava with its tip near the junction of inferior vena cava and the right atrium.The diagnosis was normal position of the umbilical venous catheter with the tip near the junction of the inferior vena cava and the right atrium.
pediatricimaging.org • CC-by-nc-sa 4.0
Premature
newborn after placement of an umbilical venous catheterAXR AP and cross-table lateral shows normal course of the umbilical venous catheter from umbilical vein to left portal vein to ductus venosus to left hepatic vein to inferior vena cava (in and cephalad on the AP view) while coursing through the liver on the lateral view with the catheter tip positioned at the junction of the inferior vena cava and right atrium. The umbilical arterial catheter has a normal course from umbilical artery to internal iliac artery to common illiac artery to aorta (in and caudad and then cephalad on the AP view) while coursing anterior to the spine on the lateral view with the catheter tip at T5. The diagnosis was appropriate position of the umbilical venous catheter and high malposition of the umbilical arterial catheter.
pediatricimaging.org • CC-by-nc-sa 4.0
Newborn after
umbilical arterial and umbilical venous catheter placementAXR AP and cross-table lateral shows normal course of the umbilical arterial catheter from umbilical artery to internal iliac artery to common illiac artery to aorta (in and caudad and then cephalad on the AP view) while coursing anterior to the spine on the lateral view with the catheter tip appropriately positioned at T7. The umbilical venous catheter has a normal course from umbilical vein to left portal vein to ductus venosus to left hepatic vein to inferior vena cava (in and cephalad on the AP view) while coursing through the liver on the lateral view with the catheter tip positioned in the right atriumThe diagnosis was appropriate position of the umbilical arterial catheter and high malposition of the umbilical venous catheter.
pediatricimaging.org • CC-by-nc-sa 4.0
Umbilical
venous catheters • Malpositioned UVC and acute hepatic fluid collection (TPNoma) - Ganzer Fall bei Radiopaedia
Ranchod A, Malpositioned UVC and acute hepatic fluid collection (TPNoma). Case study, Radiopaedia.org (Accessed on 17 Jul 2024) https://doi.org/10.53347/rID-180186 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

Umbilical venous catheters (UVCs) are commonly used in neonates for vascular access and should be carefully assessed for position on all neonatal films.

Position

An umbilical venous catheter generally passes directly superiorly and remains relatively anterior in the abdomen. It passes through the umbilicus, umbilical vein, left portal vein, ductus venosus, middle or left hepatic vein, and into the inferior vena cava.

The tip should lie at the junction of the inferior vena cava with the right atrium.

Anomalous positioning

Anomalous positioning of the umbilical venous catheters is quite frequent. The catheters are inserted by the pediatrician without imaging guidance, and given the small size of infants (especially those requiring umbilical catheters), a small variation in length of catheter can result in significant malpositioning (too long). Alternatively, the catheter may not travel along the intended route (wrong turn).

Too long

If the umbilical venous catheter is advanced too far along its intended course, the tip may end up in a number of locations:

  • left atrium and beyond (through a patent foramen ovale or an atrial septal defect)
    • pulmonary vein
    • left ventricle
  • right atrium and beyond
    • superior vena cava
    • right ventricle 
    • Wrong turn

    If the umbilical venous catheter reaches the left portal vein but does not continue into the ductus venosus, the catheter can travel left into the more peripheral left portal vein or right, where it can eventually course into the right portal vein or hepatofugally into the main portal vein (or potentially farther into the vessels that merge to form the portal vein: the superior mesenteric and splenic veins). Malpositioning within the portal venous system is associated with portal vein thrombosis.

    Complications

    Some complications can occur in a well-positioned catheter. The most common of these is formation of thrombus along the catheter.

    Malpositioned catheters may result in structural injury including:

    • hepatic hematoma from perforation of an intrahepatic vascular wall
    • pericardiac hematoma from perforation of the right or left atrial wall 

    See also

    Siehe auch:
    und weiter:
    Assoziationen und Differentialdiagnosen zu Nabelvenenkatheter:
    Komplikationen
    Nabelvenenkatheter
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    Nabelarterienkatheter
     
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    high
    malposition of the umbilical venous catheter
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