11. Two cases of pneumomediastinum in full-term newborns after uncomplicated vaginal deliveries: Various etiologies and radiographic appearances

Tóm tắt

Pnemomediastinum is defined as the presence of aberrant air in the mediastinum, also known as mediastinal emphysema. Significant pneumomediastinum is rare, particularly in term neonates. It is usually related to the different predisposing factors such as birth injury, meconium aspiration, assisted ventilation or infectious diseases although it may occur idiopathically. Pneumomediastinum is one of the important causes of respiratory distress syndrome that should not be overlook in term neonates. The elevation of thymic lobes off the heart on plain view and the presence of retrosternal air collection on lateral view are crucial signs on chest x-rays that need to be assessed cautiously by radiologists and neonatologists. We report two cases of pneumomediastinum in term infants who presented with respiratory distress. One case was diagnosed as pneumomediastinum and assisted ventilation was supposed as a predisposing factor, the other case was diagnosed as spontaneous pneumomediastinum without underlying lung disease or predisposing factors. The definitive diagnosis was made by combination plain and lateral chest x-rays without further imaging method was required. Both patients received conservative treatment with close observation clinically and radiologically and were discharged after several days in good condition.