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DOI: 10.1055/s-0039-1683862
The Value of Different Radiological Modalities in Assessment of Spontaneous Pneumomediastinum: Case Review and Diagnostic Perspective
Publikationsverlauf
29. Januar 2019
05. Februar 2018
Publikationsdatum:
07. März 2019 (online)
Abstract
Pneumomediastinum (PM), or a mediastinal air leak, is a known morbidity in neonates. Among predisposing factors, the most significant are mixed lung diseases, such as pneumonia or meconium aspiration syndrome, with coexisting atelectasis and airway obstruction. We report an unusual presentation of significant spontaneous pneumomediastinum in a term newborn delivered by elective cesarean section with no history of active resuscitation at birth.
Timely diagnosis of SPM is important for both management and prognosis. We believe that lung ultrasound (LUS) is a promising screening tool for early detection of PM in neonates, and could help avoid unnecessary exposure to radiation in delicate neonates. More simultaneous studies comparing chest X-ray (CXR), LUS, and computed tomography (CT) scans may help to prove the utility value of point-of-care ultrasounds as a primary diagnostic tool in identifying this morbidity.
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References
- 1 Carey B. Neonatal air leaks: pneumothorax, pneumomediastinum, pulmonary interstitial emphysema, pneumopericardium. Neonatal Netw 1999; 18 (08) 81-84
- 2 Steele RW, Metz JR, Bass JW, DuBois JJ. Pneumothorax and pneumomediastinum in the newborn. Radiology 1971; 98 (03) 629-632
- 3 Macklin CC. Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum: clinical implications. Arch Intern Med (Chic) 1939; 64: 913-926
- 4 Macklin MT, Macklin CC. Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions: an interpretation of the clinical literature in the light of laboratory experiment. Medicine (Baltimore) 1944; 23 (04) 281-358
- 5 Hauri-Hohl A, Baenziger O, Frey B. Pneumomediastinum in the neonatal and paediatric intensive care unit. Eur J Pediatr 2008; 167 (04) 415-418
- 6 Chalumeau M, Le Clainche L, Sayeg N. , et al. Spontaneous pneumomediastinum in children. Pediatr Pulmonol 2001; 31 (01) 67-75
- 7 Ng L, Saul T, Lewiss RE. Sonographic evidence of spontaneous pneumomediastinum. Am J Emerg Med 2013; 31 (02) 462.e3-462.e4
- 8 Russo A, Del Vecchio C, Zaottini A, Giangregorio C. Role of emergency thoracic ultrasonography in spontaneous pneumomediastinum. Two case report. G Chir 2012; 33 (8-9): 285-296
- 9 Jung AY, Yang I, Go HS. , et al. Imaging neonatal spontaneous pneumomediastinum using ultrasound. J Med Ultrason 2001 2014; 41 (01) 45-49
- 10 Okada M, Adachi H, Shibuya Y, Ishikawa S, Hamabe Y. Diagnosis and treatment of patients with spontaneous pneumomediastinum. Respir Investig 2014; 52 (01) 36-40
- 11 Kaneki T, Kubo K, Kawashima A, Koizumi T, Sekiguchi M, Sone S. Spontaneous pneumomediastinum in 33 patients: yield of chest computed tomography for the diagnosis of the mild type. Respiration 2000; 67 (04) 408-411
- 12 Panacek EA, Singer AJ, Sherman BW, Prescott A, Rutherford WF. Spontaneous pneumomediastinum: clinical and natural history. Ann Emerg Med 1992; 21 (10) 1222-1227