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Respiratory distress syndrome

Case contributed by Shailaja Muniraj
Diagnosis certain

Presentation

Twin pregnancy with oligohydraminos. Preterm and lowbirth weight newborns of 33 weeks gestational age.

Patient Data

Age: newborn
Gender: Male

Twin 1

x-ray

The bilateral lung fields show changes of hypoaeration with symmetrical diffuse reticular opacities, suggestive of respiratory distress or surfactant deficiency.  

Tip of naso-gastric tube is seen in the stomach shadow.

Twin 2

x-ray

The bilateral lung fields show changes of hypoaeration with symmetrical diffuse reticular opacities, suggestive of respiratory distress or surfactant deficiency.  

Tip of naso-gastric tube is seen in the stomach shadow.

Case Discussion

This is a case of respiratory distress syndrome in twin infants.

Initial radiographs is of low volume appearance due to alveolar atelectasis (secondary to surfactant deficiency). Later air bronchograms can be seen.

The radiologist must be aware that :

1. post intubation the lung fields appear hyper-inflated and complications such as pulmonary hemorrhage or pneumothorax can occur. 

2. when surfactant is administered via endotracheal tube, the opacities appear quite asymmetric and non homogenous.

 

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