Meconium aspiration

Case contributed by Dr Jeremy Jones

Presentation

Maternal diabetes. Cord prolapse at delivery.

Patient Data

Age: Neonate (day 0)
Gender: Female

At birth

Modality: X-ray

Artefact from babywarmer. ET tube, NG tube and UAC in situ.

Extensive patchy alveolar opacities extend through both lungs.  No effusion or pneumothorax.  Normal cardiac contour.

Day 1

Modality: X-ray

ETT just below the interclavicular line.

NG tube tip in the distal oesophagus - it should be advanced further.

UAC line tip at T9.

As demonstrated on the previous study, there are bilateral coarse alveolar opacities, but no focal collapse or pneumothorax.

Day 3

Modality: X-ray

Partial clearing of the bilateral pulmonary opacities.

Day 6

Modality: X-ray

Persistent bilateral change, but slightly increased left perihilar pulmonary opacities.

Day 7

Modality: X-ray

Increase in the bilateral pulmonary opacities, particular at the apices.

Day 8

Modality: X-ray

Increasing confluence of the bilateral pulmonary infiltrates, particularly around the hila and the apices.

Case Discussion

This is a case of meconium aspiration. Initial imaging is fairly characteristic with patchy pulmonary infiltrates and a history of a difficult delivery.

Over the series of radiographs, there is initial clearing of pulmonary infiltrates, but there is then bilateral perihilar and apical consolidation.

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Case Information

rID: 23855
Case created: 13th Jul 2013
Last edited: 8th Feb 2017
Systems: Paediatrics, Chest
Inclusion in quiz mode: Included

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