Pericardio-Peritoneal Collection in an Extremely Premature Infant: Diagnostic and Therapeutic Insights
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Updated: Nov 2, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Arvind Sehgal1, Rajiv Singh2, Kenneth Tan1
1Monash Children's Hospital, Monash University, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia.
Background:
Central venous catheterization is frequently performed in premature infants. Chest radiography may not guarantee optimal position between inferior vena cava and right atrium.
Case Summary:
An extremely premature infant (22 weeks' gestation) with an appropriately placed umbilical catheter developed abdominal distension, cardiomegaly, refractory hypotension and oxygenation failure. Point-of-care ultrasound (POCUS) confirmed the clinical suspicion of peritoneal and pericardial collections and drainage led to clinical improvements.
Discussion:
Umbilical vein catheter extravasation into the peritoneal cavity led to ascites followed by pericardial effusion via pericardioperitoneal canals.
Take-Home Messages:
Informed interpretation of clinical signs and chest radiographs, knowledge of POCUS, and inclusion of simulation-assisted procedural learning in neonatal and pediatric cardiology training programs would be beneficial. POCUS is not only useful to confirm central catheter position, but also to diagnose and manage acute complications.
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