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Age: 1 day (term)

Sex: Male

Indication: Respiratory distress

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Case #3


Findings

  • Diffuse coarse interstitial opacities, more confluent in the lung bases
  • Enteric tube in the stomach


Diagnosis

  • Meconium aspiration

Sample Report

Diffuse coarse interstitial opacities, more confluent in the lung bases which raises concern for meconium aspiration, though pneumonia can have a similar appearance.

No pleural effusions or pneumothorax.

Enteric tube in the stomach.


Discussion

  • When evaluating chest radiographs in newborns with respiratory distress, try following the decision tree in the annotated image below
  • Meconium aspiration is most often seen in term or post-term deliveries and is associated with fetal distress during labor
  • Typical radiographic findings include large lung volumes with coarse, heterogenous bilateral opacities. There can be associated pneumothorax


Images

Algorithmic approach to chest radiographs in neonates with respiratory distress.

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