Neonatal pneumothorax and lung collapse

Case contributed by Dr Ian Bickle

Presentation

Intubated for respiratory compromise.

Patient Data

Age: 1 day
Gender: Female

Endotracheal tube at just above the carina, obstructing the left main bronchus.

Complete white out of the left hemithorax without mediastinal shift in keeping with left lung collapse.

Moderate right sided pneumothorax, with the deep sulcus sign.

NG tube tip in the stomach.

X-ray

3 hours later

Endotracheal tube marginally retracted.  NG tube tip in the stomach.

UVC tip at T6/T7 disc space.   UVA tip at T11 level.

Interval right pleural drain.  Pneumothorax almost completely resolved.

The left lung has re-expanded.

Case Discussion

The first radiograph has bilateral pathology causing respiratory compromise, which was quickly rectified by prompt medical intervention.

A right sided neonatal pneumothorax required intubation which temporarily inadvertently caused a contralateral left lung collapse due to the low endotracheal tube position.

Repositioning of the endotracheal tube and a pleural drain insertion lead to a much improved second radiograph just a few hours later.

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Case information

rID: 85909
Published: 14th Jan 2021
Last edited: 14th Jan 2021
System: Chest
Inclusion in quiz mode: Included

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