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
