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Age: 6 days (term)

Sex: Male

Indication: Respiratory distress, abdominal distension

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Case #2


Findings

  • Gas-filled loops of bowel overlying the left hemithorax
  • Rightward mediastinal shift
  • Nonenlarged cardiothymic silhouette
  • Pneumatosis involving loops of bowel in the left hemiabdomen with a paucity of bowel gas in the right hemiabdomen
  • No portal venous gas or evidence of pneumoperitoneum
  • Endotracheal tube tip projects 1.5 cm above the carina
  • Gastric tube overlies the left upper quadrant
  • Umbilical venous catheter projects near the expected located of the inferior cavoatrial junction
  • Umbilical arterial catheter tip overlies the T7-T8 level


Diagnosis

  • Necrotizing enterocolitis (NEC)

Sample Report

Findings consistent with left congenital diaphragmatic hernia. Associated rightward mediastinal shift. Both lungs are well-aerated.

Pneumatosis involving loops of bowel in the left hemiabdomen without portal venous gas or evidence of pneumoperitoneum.


Discussion

  • It is easier to tell if gas is intraluminal or intramural along the lateral aspects of the abdomen where there are not so many overlapping bowel loops



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