Lung DOI 10.1007/s00408-014-9601-x
Neonatal Spontaneous Pneumomediastinum L. Franco • F. Vieira • M. Marc¸al • M. Tuna
Received: 3 May 2014 / Accepted: 19 May 2014 Ó Springer Science+Business Media New York 2014
We present the case of a male newborn, admitted to our unit 4 hours after delivery with respiratory distress syndrome. Born by normal vaginal delivery at 39 weeks of gestation after an uncomplicated pregnancy, weighing 3,070 g, with Apgar score 9/10, he presented with progressive respiratory distress (grunting, tachypnea, nasal flaring, and intercostal retractions) starting one hour after delivery, with mild hypoxemia that resolved with oxygen therapy. Chest radiograph revealed a large pneumomediastinum (Fig. 1a, b). Infection was excluded, and there was
a good clinical response to oxygen therapy, with no need for ventilatory support. Serial chest radiographs showed complete resolution. The infant was discharged home at eight post natal days. Pneumomediastinum occurs in about 2.5 to 1000 births and is usually associated with mechanical ventilation, pneumonia, meconium aspiration, or birth-related trauma [1]. Spontaneous pneumomediastinum such as the one we describe is a rare entity [2, 3].
L. Franco (&) F. Vieira M. Marc¸al M. Tuna Neonatal Intensive Care Unit - NICU, Pediatric Service, Centro Hospitalar de Lisboa Ocidental, Estrada Forte do Alto do Duque, 1449-005 Lisboa, Portugal e-mail: [email protected]
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References 1. Hauri-Hohl A, Baenziger O, Frey B (2008) Pneumomediastinum in the neonatal and paediatric intensive care unit. Eur J pediatr 167:415–418 2. Akin K, Cizmeci M, Kanburoglu M, Akelma A, Tatli M (2013) Angel wing sign in a neonate with pneumomediastinum. J Pediatr 163(1):296 3. Correia-Pinto J, Henriques-Coelho T (2010) Neonatal spontaneous pneumomediastinum and the spinnaker-sail sign. N Engl J Med 363:2145
Fig. 1 Chest radiographs of a neonate (a admission; b third day of life) showing bilateral radiolucent areas alongside the heart, and elevation of both thymic lobes—the angel sign; this results from the presence of free mediastinal air that lifts the thymus off of the heart and major vessels
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Neonatal Spontaneous Pneumomediastinum L. Franco • F. Vieira • M. Marc¸al • M. Tuna
Received: 3 May 2014 / Accepted: 19 May 2014 Ó Springer Science+Business Media New York 2014
We present the case of a male newborn, admitted to our unit 4 hours after delivery with respiratory distress syndrome. Born by normal vaginal delivery at 39 weeks of gestation after an uncomplicated pregnancy, weighing 3,070 g, with Apgar score 9/10, he presented with progressive respiratory distress (grunting, tachypnea, nasal flaring, and intercostal retractions) starting one hour after delivery, with mild hypoxemia that resolved with oxygen therapy. Chest radiograph revealed a large pneumomediastinum (Fig. 1a, b). Infection was excluded, and there was
a good clinical response to oxygen therapy, with no need for ventilatory support. Serial chest radiographs showed complete resolution. The infant was discharged home at eight post natal days. Pneumomediastinum occurs in about 2.5 to 1000 births and is usually associated with mechanical ventilation, pneumonia, meconium aspiration, or birth-related trauma [1]. Spontaneous pneumomediastinum such as the one we describe is a rare entity [2, 3].
L. Franco (&) F. Vieira M. Marc¸al M. Tuna Neonatal Intensive Care Unit - NICU, Pediatric Service, Centro Hospitalar de Lisboa Ocidental, Estrada Forte do Alto do Duque, 1449-005 Lisboa, Portugal e-mail: [email protected]
123
Lung
References 1. Hauri-Hohl A, Baenziger O, Frey B (2008) Pneumomediastinum in the neonatal and paediatric intensive care unit. Eur J pediatr 167:415–418 2. Akin K, Cizmeci M, Kanburoglu M, Akelma A, Tatli M (2013) Angel wing sign in a neonate with pneumomediastinum. J Pediatr 163(1):296 3. Correia-Pinto J, Henriques-Coelho T (2010) Neonatal spontaneous pneumomediastinum and the spinnaker-sail sign. N Engl J Med 363:2145
Fig. 1 Chest radiographs of a neonate (a admission; b third day of life) showing bilateral radiolucent areas alongside the heart, and elevation of both thymic lobes—the angel sign; this results from the presence of free mediastinal air that lifts the thymus off of the heart and major vessels
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