Pneumoperitoneum and respiratory distress syndrome

Case contributed by Dr Jeremy Jones

Presentation

24+1 weeks gestation. 1 week old. Increasing oxygen requirement.

Patient Data

Age: 7 days
Gender: Male

ETT, NGT, UAC and UVC with positions appropriate (UVC slightly low).

Background granular appearance of both lungs consistent with RDS.

Large volume pneumoperitoneum outlining the falciform ligament: the football sign.

Confirmation of large volume pnuemoperitoneum.

Multiple loops of gas-filled bowel. Mural gas within left-sided bowel loops. Appearances of necrotizing enterocolitis.

Case Discussion

Necrotizing enterocolitis (NEC) complicated by perforation with a large volume of gas in the peritoneal cavity. Neonatal pneumoperitoneum is most commonly seen in NEC and is often seen in preterm babies who have respiratory distress syndrome.

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Case information

rID: 62734
Published: 29th Aug 2018
Last edited: 17th Jun 2021
System: Paediatrics
Inclusion in quiz mode: Included
Institution: NHS Lothian

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