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Age: 2 days (term)

Sex: Male

Indication: Transient tachypnea of the newborn

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Case #33


Findings

  • Enteric tube tip overlies the stomach
  • Lucency outlining the mediastinum and uplifting and laterally displacing the thymus
  • Diffuse groundglass opacification of both lungs
  • No definite pleural effusion or pneumothorax
  • Normal size of the cardiothymic silhouette


Diagnosis

  • Pneumomediastinum (spinnaker sail sign)
  • Transient tachypnea of the newborn (TTN)

Sample Report

Enteric tube tip overlies the stomach.

Lucency outlining the mediastinum and uplifting and laterally displacing the thymus (spinnaker sail sign) consistent with pneumomediastinum.

Diffuse groundglass opacification of both lungs consistent with the patient’s diagnosis of transient tachypnea of the newborn.

No definite pleural effusion or pneumothorax.

Normal size of the cardiothymic silhouette.


Discussion

  • The spinnaker sail sign results when mediastinal gas outlines, uplifts, and laterally displaces the thymus (more often to the right, but it is to the left in this case)
  • Additional imaging signs of pneumomediastinum include vertically-oriented linear lucencies extending into the neck and the continuous diaphragm sign due to air dissecting inferiorly along the pericardium


Images

Spinnaker sail appearance of the thymus due to pneumomediastinum.

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