An Aberrant Position of Peripherally Inserted Central Venous Catheter in Extreme Preterm Infant

The use of a Percutaneously inserted central catheter (PICC) has increased with improved survival of extremely premature infants. Catheter malposition and perforation are associated with serious complications. PICC line position always needs to be confirmed after insertion. An Anteroposterior (AP) view radiograph is commonly used to confirm catheter tip position. We report a case of an unusual PICC position despite confirmation of the PICC tip position on the AP view radiograph. It is a potentially fatal complication and timely intervention can be lifesaving. Performing lateral X-rays to confirm the PICC tip or USG-guided placement of the catheter tip can prevent untoward serious complications. In the case of ascites, upper-extremity catheter insertion should be preferred instead of lower-extremity central venous catheters.