Presentation
Respiratory distress.
Patient Data
Hyperexpanded right middle lobe with compressive atelectasis of the right upper and lower lobes. There is contralateral mediastinal shift.
The NGT tube is in the distal esophagus, needs to be advanced further.
Case Discussion
Hyperexpanded right middle lobe with compressive atelectasis of the right upper and lower lobes. There is contralateral mediastinal shift.
Findings suggest right middle lobe congenital lobar emphysema. The right middle lobe is the second most common location for this condition (~30%) with left upper lobe involvement being most common (40-45%).
It is also always important to check the position of lines and tubes in neonates (as with adults). In this case the NGT tip is within the distal esophagus and requires further insertion.
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