PMC6406024_01
CXR-early alveolar changes showing bilateral air-bronchograms on day 1 of life. CXR, chest X-ray.
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His blood gases showed metabolic acidosis and chest X-ray (CXR) showed air-bronchograms in both lungs with an ill-defined cardiac border ( Fig. 1 ).
CXR-bilateral hyperlucent shadows in superior medial hemithoraces over the area of pneumomediastinum on day 2 of life. AP, anteroposterior; CXR, chest X-ray.
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Subsequent CXRs showed that the previously described hyperlucent shadow became more evident bilaterally ( Fig. 2 ).
LUS-presence of multiple "A" lines, absence of "B" lines and no pleural shimmering. LUS, lung ultrasound.
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Bedside lung ultrasound (LUS) on day-2 of life showed the classic "bar-code" sign suggestive of an air-leak rather than air-filled cystic mass ( Figs. 3 , 4 ).
LUS-M-mode with classic "bar-code" sign over the area of pneumomediastinum. LUS, lung ultrasound; M-mode, motion over time.
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Bedside lung ultrasound (LUS) on day-2 of life showed the classic "bar-code" sign suggestive of an air-leak rather than air-filled cystic mass ( Figs. 3 , 4 ).
CT scan-showing expanding air in the mediastinum (arrows) causing adjacent atelectasis within the medial aspects of both right and left upper lobes of lungs by day 3 of life. CT, computed tomography.
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Computerized tomography (CT) scan of the chest was requested to confirm the presence of a large extensive pneumomediastinum, expanding in the mediastinum and causing soft tissue gas to extend into the right side of the neck ( Fig. 5 ).