IS case 491: Pulmonary interstitial emphysema

Neal Young, MD

University of Rochester

Imaging Sciences URMC 2010
Publication Date: 2010-08-30

History

Patient is a 3-day-old premature infant on ventilatory support and worsening pulmonary status.

Findings

See images

Diagnosis

Pulmonary interstitial emphysema

Discussion

In premature infants with surfactant deficiency, the terminal air sacs lack the ability to stay distended. Consequently, positive pressure ventilation is required to avoid hypoxemia and acidosis.

Barotrauma can occur due to the poor compliance of the lungs and rupture of the air sacs may lead to air leak into the pulmonary interstitium. The streaky appearance is usually peripheral, but can migrate centrally and even progress to pneumomediastinum.

References

  1. Blickman JG, Parker BR, Barnes PD. Pediatric Radiology: The Requisites, 3rd ed. Mosby, 2009:26-28.

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