Pulmonary interstitial emphysema

Case contributed by The Radswiki
Diagnosis almost certain

Intubated neonate.

Hyperlucent right hemithorax with multiple interstitial bubble-like lucencies that radiate from the hila. Radiating bands of increased density represent blood vessels surrounded by interstitial gas and compressed interstitium.

Features are of pulmonary interstitial emphysema in a preterm neonate who has probably got RDS.

Case Discussion

There are radiating bubble-like lucencies from the hilum of both lungs, greater on the right.  Features here are of pulmonary interstitial emphysema which has occurred secondary to over-ventilation.

Oftentimes, the clinical teams simply adjust ventilatory pressures and watch as the chest radiograph findings resolve.

These images are from Dr. Paula Brill's excellent pediatric radiology collection. Dr. Brill is a professor in the department of radiology (pediatric section) at Weill Cornell. This case was donated to Radiopaedia.org by Radswiki.net

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