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Age: 0 days (term)

Sex: Female

Indication: Meconium aspiration

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Case #7


  • Large right and small left pneumothoraces
  • Leftward shift of the cardiothymic silhouette
  • Minimal retrocardiac airspace opacification


  • Pneumothorax

Sample Report

Large right and small left pneumothoraces. Leftward shift of the cardiothymic silhouette raises concern for associated tension physiology.

Minimal retrocardiac airspace opacification, which may relate to atelectasis or aspiration.


  • Pneumothorax is common with meconium aspiration, report to occur in about 1/4 to 1/3 of cases, but can also occur with many other pathologies including pulmonary hypoplasia (Potter sequence) and barotrauma
  • While this case is fairly obvious, smaller pneumothoraces can be difficult to identify in neonates. Look for air along or overly clear delineation of the cardiothymic silhouette (air will move anteriorly in a supine patient)


Red arrows: bilateral pneumothoraces. Red dotted oval: note the lucency along and overly clear delineation of the right heart border, which can sometimes be the only sign of pneumothorax.

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