A.Sheta

I would suggest a Lt lateral decubitus x-ray as there's a query translucency within the liver shadow which may reflect a ?pneumoperitoneum

There's one article with a title of " Increased success rate in umbilical venous Catheter positioning by posterior liver mobilization" published in 2010 in Archives de Pediatrie in french language.The abstract was in English & french( but the whole article was in french). The authors(in the abstract) described a 50% higher incidence of successful UVC position with postero-lateral mobilization of the liver. Personally; I didn't try that described technique ,meanwhile, I tried many times to insert a 2nd UVC (if the first one is hepatic in position) but it has never worked out. I'm currently testing a corrective technique for improperly positioned UVC but not yet ready to declare further details about it. I think the literature about umbilical venous catheterization is lacking about corrective techniques for an improperly positioned UVC and this would be a good field of research.