Case Report
Year: 2022 | Month: April | Volume: 12 | Issue: 4 | Pages: 160-162
DOI: https://doi.org/10.52403/ijhsr.20220420
Spontaneous Neonatal Pneumomediastinum - A Case Report
Dr. Asfia Banu1, Dr. Anusha B2
1,2 Department of Pediatrics and Neonatology, Shifaa Hospital, Bangalore
Corresponding Author: Dr. Asfia Banu
ABSTRACT
Neonatal pneumomediastinum has been found to occur in approximately 2.5 per 1000 live births. It is a benign and self-limiting condition in neonates. It can be symptomatic or asymptomatic but resolves with appropriate supportive and conservative treatment. Close monitoring in such babies is essential.
In this case report, presenting a boy baby born by an uncomplicated normal vaginal delivery with no resuscitation manoeuvres required and a good APGAR score of 8/10 and 9/10 at 1 minute and at 5 minutes of life. This baby was having tachypnoea since the time of birth which worsened to respiratory distress with grunting and intercostal retractions by 2 hours of life. A Chest X ray was done, which showed pneumomediastinum. As the baby was not maintaining saturation with hood box oxygen and the distress was quite severe, we started high flow oxygen by nasal cannula. As the saturation was maintaining and there was clinical improvement in the baby, the high flow oxygen was gradually weaned off by Day 11 of life and the baby was discharged in a stable state.
Pneumomediastinum is a diagnosis made by clinical observation as well as by radiology. Though it is a benign condition, an oxygen rich environment is the main stay of treatment and close observation for worsening distress or development of pneumothorax / subcutaneous or interstitial emphysema is necessary.
In this case, baby developed the pneumomediastinum spontaneously with no antenatal or perinatal risk factors. The vigorous respiratory efforts by the baby and vigorous crying at birth led to alveolar rupture, thereby leading to the pneumomediastinum. The pneumomediastinum was so severe that it took 11 days to resolve completely.
Key words: pneumomediastinum, spontaneous, neonatal, oxygen.