Riverside Health Care System, Inc.

[This corrects the article DOI: 10.7759/cureus.93956.].

Indwelling medical devices such as central venous catheters (CVCs), ureteral stents, ventriculoperitoneal (VP) shunts, inferior vena cava (IVC) filters, percutaneous endoscopic gastrostomy (PEG) tubes, and nasogastric (NG) tubes are integral to modern clinical care. Malposition or migration, however, can result in severe complications, including vascular injury, organ perforation, infection, and obstruction. Radiologists are often the first to detect these complications, but interpretation may be challenging due to variable device types, insertion techniques, and patient anatomy.

We conducted a retrospective case-based review of malpositioned indwelling devices encountered in clinical practice at our institution. Each case was analyzed individually with attention to device type, insertion pathway, radiographic landmarks, abnormal positioning patterns, and associated complications. Representative examples were selected to create a pictorial review highlighting imaging pearls and diagnostic pitfalls.

The cases illustrate a wide spectrum of malposition patterns across commonly placed devices. Vascular access complications included arterial cannulation, aberrant venous placement, and migration into unexpected vascular channels. Ureteral stent malpositions demonstrated distal migration into the urethra and proximal perforation through the renal cortex. VP shunt cases showed distal extrusion into hollow viscera such as the rectum. IVC filter malpositions included tilt, strut perforation, and extension into adjacent organs. PEG tube malpositions resulted in intraperitoneal leakage and peritonitis, while NG tube misplacements involved tracheobronchial insertion and gastric perforation. These examples highlight both typical and rare presentations, underscoring the importance of systematic radiographic evaluation.

This retrospective case series and pictorial review underscore the critical role of radiologists in recognizing malpositioned indwelling devices. Accurate interpretation requires a structured imaging approach, correlation with clinical context, and familiarity with device-specific pitfalls. By presenting illustrative examples across multiple device types, this work provides a practical reference to enhance radiologic vigilance, improve diagnostic accuracy, and ultimately prevent adverse outcomes in patients with indwelling catheters and medical devices.

STING‑associated vasculopathy with onset in infancy (SAVI) is a rare autoinflammatory disorder that causes systemic inflammation, vasculopathy, and progressive interstitial lung disease (ILD). The pulmonary manifestations of SAVI typically resemble a nonspecific interstitial pneumonia (NSIP) pattern both radiologically and histologically. We present a case of a 20‑year‑old male with genetically confirmed SAVI who developed acute hypoxic respiratory failure triggered by respiratory syncytial virus infection, despite appropriate treatment. Imaging revealed extensive subpleural fibrosis, traction bronchiectasis, and honeycombing. These findings were observed in the setting of a CT appearance strongly consistent with a definite usual interstitial pneumonia (UIP) pattern. Ultimately, the patient underwent a lung transplant, and histopathology of the explanted lungs revealed fibrotic changes, including diffuse interstitial thickening, lymphoid aggregates, and honeycombing, without definitive fibroblastic foci, indicating a mixed UIP and NSIP pattern of fibrosis. This case illustrates a rare UIP‑pattern imaging phenotype in SAVI‑associated ILD, despite a mixed UIP‑NSIP histologic pattern of pulmonary fibrosis, and highlights the potential for acute viral infection to precipitate decompensation in patients with interferon‑driven pulmonary fibrosis. Written informed consent was obtained from the patient for publication of this report and accompanying images.