Neonatal spontaneous pneumomediastinum.

Abstract

We present the case of a male newborn, admitted to our unit 4 hours after delivery with respiratory distress syndrome. Born by normal vaginal delivery at 39 weeks of gestation after an uncomplicated pregnancy, weighing 3,070 g, with Apgar score 9/10, he presented with progressive respiratory distress (grunting, tachypnea, nasal flaring, and intercostal retractions) starting one hour after delivery, with mild hypoxemia that resolved with oxygen therapy. Chest radiograph revealed a large pneumomediastinum (Fig. 1a, b). Infection was excluded, and there was a good clinical response to oxygen therapy, with no need for ventilatory support. Serial chest radiographs showed complete resolution. The infant was discharged home at eight post natal days. Pneumomediastinum occurs in about 2.5 to 1000 births and is usually associated with mechanical ventilation, pneumonia, meconium aspiration, or birth-related trauma [1]. Spontaneous pneumomediastinum such as the one we describe is a rare entity [2, 3].