Interrupted inferior vena cava with azygos continuation in an extreme preterm infant: Unusual lower-limb peripherally inserted central catheter line tip position

Abstract

We report a case of interrupted inferior vena cava (IVC) with azygos continuation in an extremely preterm infant born at 23 weeks of gestation. This anomaly was detected after the insertion of lower-limb peripherally inserted central catheter. The tip of the catheter on lateral chest X-ray was in an unusual position as the catheter continued to run anterior to the spinal vertebrae and posterior to the umbilical arterial catheter within the aorta on two separate insertion attempts. Ultrasound Doppler and echocardiogram confirmed the diagnosis of interrupted IVC with azygos continuation. Neonatal practitioners need to be aware of this anomaly to avoid unnecessary interventions.