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Newborn with intermittent grunting in the first hours after delivery
  1. Paul H G Hogeman1,
  2. Willem B de Vries2,
  3. Jolmer J Smit3,
  4. David C van der Zee4
  1. 1Meander Medisch Centrum, Department of Paediatrics
    Amersfoort, the Netherlands
  2. 2Wilhelmina Kinderziekenhuis, Department of Neonatology
    Utrecht, the Netherlands
  3. 3Meander Medisch Centrum, Department of Paediatrics
    Amersfoort, the Netherlands
  4. 4Wilhelmina Kinderziekenhuis, Department of Paediatric Surgery
    Utrecht, the Netherlands
  1. Dr P H G Hogeman, Meander Medisch Centrum, Ringweg Randenbroek 110, 3816 CP Amersfoort, the Netherlands; p.hogeman{at}meandermc.nl

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Figure 1 Chest x ray before referral to the neonatal intensive care unit. Large amounts of intestines in the left thorax are seen pushing the lung tissue towards the apex and the heart to the right. The stomach is in the abdominal cavity, but few intestinal loops are seen here.

A newborn baby boy (42 weeks’ gestation with good start, Apgar scores 9,10) developed intermittent grunting with slight subcostal retractions in the first hours after birth. At first heart sounds were audible on the left side, but within two hours these shifted to the right side …

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