Presentation
Premature delivery, post-intubation and insertion of UVC.
Patient Data
The lung fields are hyperinflated with surfactant deficiency disorder. There is a normal cardiomediastinal contour and a central trachea. The endotracheal tube (ETT) is infraclavicular. There are overlying ECG leads. There is a rectal temperature probe in situ and an overlying temperature lead. The umbilical venous catheter (UVC ) is present. There is an artifact from an overlying thermal wrap. There is a normal bowel gas pattern (within the first 24 hours). There are 12 pairs of ribs. The humeral ossification centers are absent, in keeping with prematurity.
Case Discussion
An example of the artifact caused by the overlying thermal wrap/blanket in a premature infant with surfactant deficiency disorder.
The extra-abdominal artifact and close contact with the lateral abdominal wall are consistent with the tight wrapping/tucking of the wrap around the infant to retain heat. In addition, note the geographic, symmetric, and regular patterned nature of the artifact. These two findings assist in interpreting the appearance as artifactual rather than surgical emphysema or free intraperitoneal air. This differentiation can be difficult on odd occasions (see companion cases rID 192511 and rID 192516).