Spontaneous pneumomediastinum in a term neonate – case report

Abstract

Key Clinical MessagePneumomediastinum after birth, without birth injury or resuscitation maneuvers, is an unusual situation that can present with grunting, deafening of cardiac sounds, and bulging of the hemithorax. If clinical condition allows, conservative approach is advised even if the pneumomediastinum does not spontaneously resolve in 1 or 2 days.

A rare cause of respiratory distress in a newborn: Pneumomediastinum

“…In our patient's chest X-ray, the typical "spinnaker-sail sign" due to the elevation of the thymus confirmed the diagnosis of pneumomediastinum. The presence of any mediastinal mass was ruled out by CT. Pneumomediastinum resolves with supportive conservative treatment, with or without oxygen therapy, in most of the cases [3]. Similar to the cases reported in the literature, our case had a spontaneous resolution [7].…”

“…Similar to the cases reported in the literature, our case had a spontaneous resolution [7]. Deterioration of the clinical status due to pneumothorax, subcutaneous interstitial emphysema, and the need for drainage and mechanical ventilation had been reported in severe cases [3,9]. Pneumomediastinum is a rare cause of respiratory distress and initial diagnosis by chest X-ray can be difficult in some cases.…”

“…The incidence of pneumomediastinum was detected in 2.3% and 1% in vaginal and caesarean section deliveries, respectively. According to their study, apparent predisposing or associated factors included intubation, congenital anomalies, and meconium-stained amniotic fluid while no significant correlation was found for prematurity, dysmaturity, small size for age, caesarean section, or hyaline membrane disease [1,3].…”

“…Pneumomediastinum is a benign, self-limiting condition in neonates [3]. It occurs in approximately 2.5 per 1000 live births [1].…”

Spontaneous Pneumomediastinum in a Term Neonate: A Case Report

“…Our baby boy was born at term by spontaneous vaginal delivery, did not receive any resuscitation, only required nasal cannula oxygen for few hours. This could be explained by the pressure gradient between the alveolar and perivascular space that could be abnormally high during crying of the baby and an alveolar rupture may occur [6]. Chest x-ray is usually enough to diagnosis pneumomediastinum, it may show a halo around the heart border or air elevating the thymus and giving rise to a crescentic configuration and a windblown spinnaker sail as in our patient [7,8].…”