Neonatal Med.  2020 Feb;27(1):21-25. 10.5385/nm.2020.27.1.21.

A Case of Neonatal Pneumomediastinum with Subcutaneous Emphysema Suspected to Be Caused by Pharyngoesophageal Injury

• Lee SH
• Kim JK

• KMID: 2502089
• DOI: http://doi.org/10.5385/nm.2020.27.1.21

Abstract

Iatrogenic esophageal perforation is a rare condition in children, but occasionally occurs in premature infants due to repeated intubation or nasogastric tube insertion. Esophageal perforation is common in pneumothorax and interstitial emphysema, but rarely occurs in the absence of pneumothorax. Although complications, such as mediastinitis, after esophageal perforation are rare, they can be fatal. Therefore, rapid and accurate diagnosis and appropriate treatment are important. The authors report a case of huge retrocardiac pneumomediastinum and subcutaneous emphysema suspected to be caused by esophageal perforation after repeated intubation.

Keyword

Mediastinal emphysema perforation; Pneumomediastinum; Subcutaneous emphysema; Newborn

Figure

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  Figure 1. Chest radiographs of a premature infant. Chest radiographs captured on the day of birth (A, B) reveal ground-glass opacities in both lung fields and a small quantity of air in the mediastinum.

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  Figure 2. Chest radiographs of a premature infant. Chest radiographs captured 7 days after birth (A, B) reveal extended radiolucency at both paravertebral areas (arrow), suggesting pneumomediastinum extending to the middle thoracic esophagus.

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  Figure 3. Chest computed tomography (CT) scans of a premature infant. Axial (A) and coronal (B) CT scans performed 7 days after birth reveal huge retrocardiac pneumomediastinum surrounding the esophagus and extending to the diaphragm (arrow). The orogastric tube is evident near the pneumomediastinum (arrow).

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