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Age: 0 days (term)

Sex: Male

Indication: Increased oxygen requirement

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Case #12


Findings

  • Small to moderate-sized left pneumothorax
  • Mild rightward mediastinal shift
  • Paradoxical lucency throughout the left lung
  • Normal size and configuration of the cardiothymic silhouette
  • Small bore enteric tube with tip overlying the distal thoracic esophagus


Diagnosis

  • Pneumothorax
  • Congenital lobar emphysema (aka congenital lobar overinflation)

Sample Report

Small to moderate-sized left pneumothorax with mild rightward mediastinal shift. Recommend correlation with clinical signs of tension.

Paradoxical lucency throughout the left lung, which may relate to pleural gas collecting anteriorly, though an underlying lung abnormality such as congenital lobar emphysema could have a similar appearance. Recommend attention on followup radiographs.

Small bore enteric tube with tip overlying the distal thoracic esophagus. Recommend advancement if intragastric placement is desired.


Discussion

  • Small pneumothoraces can be difficult to identify in young children. Look for air along or overly clear delineation of the cardiothymic silhouette (air will move anteriorly in a supine patient)



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