Perinatology.  2016 Dec;27(4):264-267. 10.14734/PN.2016.27.4.264.

Multiseptated Cystic Pneumomediastinum in a Term Newborn: Cystic and Bubbly Lesion on Chest X-ray

• Kang HG
• Seo HJ

• KMID: 2367040
• DOI: http://doi.org/10.14734/PN.2016.27.4.264

Abstract

In general, pneumomediastinum occurs in newborns with underlying lung problems, particularly when a ventilator is needed. Spontaneous pneumomediastinum without preceding assisted ventilation, and presenting as a huge cystic mass in a term newborn infant has rarely been reported. This case baby was delivered vaginally at term and developed respiratory distress after birth. The finding of artery blood gas analysis shows severe respiratory acidosis. Initial chest X-rays obtained on admission revealed the presence of a large quantity of air in the mediastinum and pneumothorax. On the third day of admission, the baby showed no respiratory symptoms and signs. However, the cystic and bubbly lesion on the mediastinum remained in chest X-rays. A chest computed tomography (CT) was performed to determine the origin of the cystic lesion. The CT revealed multiseptated cystic pneumomediastinum on the anterior mediastinum and over the anterior region of both lungs. We report a term neonate with spontaneous multiseptated cystic pneumomediastinum suspected as congenital mediastinal cystic mass.

Keyword

Pneumomediastinum; Term infant; Mediastinal cyst

MeSH Terms

Acidosis, Respiratory
Arteries
Blood Gas Analysis
Humans
Infant, Newborn*
Lung
Mediastinal Cyst
Mediastinal Emphysema*
Mediastinum
Parturition
Pneumothorax
Thorax*
Ventilation
Ventilators, Mechanical

Figure

• 

  Fig. 1 (A) On the 1st day of life, the chest X-ray showed large radiolucent mediastinal lesions on the anterior mediastinum, including the neck (big arrows) and pneumothorax (small arrows), on both lungs. (B) On the 3rd day of life, the chest X-ray showed decreased pneumothorax lesions. However, the cystic radiolucent lesion on the mediastinum remained.

• 

  Fig. 2 On the 3rd day of life, the chest CT showed multiseptated cystic pneumomediastinum in the anterior mediastinum and over the anterior region of both lungs.

• 

  Fig. 3 On the 19th day of life, the pneumomediastinum almost completely disappeared from the chest radiograph.

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