Ultrasound-guided UVC 2_Umbilical Venous Catheter Malposition (Kozyak et al)
Channel: Benjamin Kozyak, MD
Date: 27/01/2022

Here we demonstrate assessment of umbilical venous catheter malposition using ultrasound.

When a UVC is referred to as “stuck in the liver”, the catheter may be malpositioned in either the left or right portal veins.

Here is a radiograph of a UVC malpositioned in a left portal vein.  The overlaid illustration highlights the anatomy.

Portal veins may be distinguished by their echo bright endothelium.  

In sagittal US imaging, the left portal vein is seen at top left, branching cephalad off the portal sinus.  The LPV is highlighted in pink.  The umbilical venous catheter is also seen in this image, highlighted in blue.

Here you can see the UVC that has become caught in the left portal vein, rather than advancing posteriorly through the portal sinus.

We will now look at catheters caught in the right portal veins, as shown in this radiograph and overlaid illustration.  

Here, the UVC can be seen dropping posteriorly through the PS.

The right portal veins join the portal sinus more posteriorly, and are usually out of plane relative to the left portal veins, umbilical vein, and ductus venosus.  The right portal veins are highlighted here in pink, and the UVC again in blue.

This next frame shows the right portal veins deeper in the liver, with a malpositioned catheter seen within at left.

Thank you.

"Ultrasound-guided UVC 2_Umbilical Venous Catheter Malposition"
By: Benjamin Kozyak MD (https://www.youtube.com/channel/UCo4gPV2X0y2hx60-RxRLWcQ)
Creative Commons License: CC BY (https://creativecommons.org/licenses/by/4.0/legalcode)