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QUIZ No. 18
A late preterm (35 weeks) neonate presented with respiratory distress shortly after birth. The infant was managed with exogenous surfactant therapy and required mechanical ventilation for respiratory support. Chest X-ray was performed. What is your diagnosis?
X-ray Immediately After birth
1 week Follow up
ANS – Pulmonary interstitial emphysema
Findings - Multiple linear and cystic lucencies are visible bilaterally, predominantly in the central and peri-bronchovascular distribution(L>R). Left-sided pneumothorax with hyperinflation of the left lung. Volume loss in the right hemithorax. Follow-up CXR shows interval reduction in interstitial air lucencies, indicating partial resolution of PIE.
Premature Neonate
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Surfactant Deficiency + Mechanical Ventilation
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Uneven Alveolar Expansion → Overdistension
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Alveolar Wall Rupture (fragile immature lungs)
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Air Leaks into Perivascular Interstitium
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Dissection of Air Along Bronchovascular Sheaths
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Formation of Interstitial Air Pockets (Cystic Lucencies)
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Compression of Adjacent Lung Parenchyma
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↓ Oxygenation + Risk of Barotrauma
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Potential Complications:
* Pneumothorax
* Pneumomediastinum
* Respiratory Failure
* Bronchopulmonary Dysplasia
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