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Images in neonatal medicine
Tension pneumomediastinum with subcutaneous emphysema
  1. Jin Yong Jeong1,
  2. Seong Woo Nam2,
  3. Bo-Kyung Je3,
  4. Byung Min Choi2
  1. 1Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Ansan Hospital, Ansan-Si, Gyeonggi-Do, Korea
  2. 2Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
  3. 3Department of Diagnostic Radiology, Korea University College of Medicine, Seoul, Korea
  1. Correspondence to Professor Byung Min Choi, Department of Pediatrics, Korea University Ansan Hospital, #516, Gojan-Dong, Danwon-Gu, Ansan-Si, Gyeonggi-Do 425–707, Korea; cbmin{at}korea.ac.kr

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Case

A male infant born at 38+1 weeks' gestation by spontaneous vaginal delivery at a regional maternity hospital weighed 2860 g. No active resuscitation was required apart from gentle oropharyngeal suctioning. At 8 h of age, progressive respiratory distress with tachypnoea and subcostal retractions developed. Dyspnoea and desaturation persisted despite supplemental oxygen of 3 l/min in the incubator. Acute swelling of the upper thorax, neck and scalp were noted at 24 h of age.

On arrival to the neonatal intensive care unit, there were no other significant abnormalities noted except for marked …

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