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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2019; 29(01): 94-97
DOI: 10.4103/ijri.IJRI_447_18
Case Report

Ultrasonography and X-Ray guided drain placement to evacuate a pneumopericardium/pneumomediastinum in a 1-day-old infant

Ambarish P Bhat
Department of Radiology, Vascular and Interventional Radiology, University of Missouri, Columbia
,
Ashwin Pimpalwar
Division of Pediatric Surgery, Department of Surgery, University of Missouri Health Care, Children’s Hospital, Columbia
,
Peter C Dyke II
Children’s Hospital Cardiology Center, Women’s and Children’s Hospital, University of Missouri Health Care, Columbia, USA
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Subject Editor: Financial support and sponsorship Nil.
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Abstract

Ultrasonographic (US) guided procedures have wide range of application in the abdomen and pelvis, however their role is somewhat limited in the chest due to complete reflection of the ultrasound beam by the air in the lungs, preventing the direct imaging of the tissues deep to the air-sound interface. Most of the chest procedures, other than the exception of thoracentesis, rely on the use of CT (computed tomography) scan. The disadvantages of using CT scan is the cost, lack of portability, and most importantly the radiation involved, particularly in case of infants and children, whose tissues are more radiosensitive than the adults. Identification of air by Ultrasonography can help direct needles and wires, to accomplish procedures which may otherwise need CT. A 1-day-old infant with respiratory distress syndrome (RDS) on a ventilator, developed an expanding symptomatic pneumopericardium/pneumomediastinum. The patient was too unstable to leave the neonatal intensive care unit (NICU), so a pericardial/mediastinal drain was placed under ultrasonographic and radiographic guidance. This case, highlights a method for bedside treatment of pneumopericardium/pneumomediastinum in an unstable neonate. This procedure may be equally effective in older children and adults.

Keywords

Cardiac tamponade - pneumomediastinum - pneumopericardium - respiratory distress syndrome - ultrasound guided drain of pneumopericardium


Publication History

Article published online:
23 July 2021

© 2019. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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