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This baby was brought to medical attention at 1 hour of age. The birth was a normal spontaneous vaginal delivery, after an uneventful pregnancy. Examination revealed an absent left sternomastoid muscle with paradoxical movement of the soft tissues in the left supraclavicular space. This was more pronounced on crying, as illustrated in figs 1 and 2. The rest of the clinical examination was unremarkable. The swelling seen superior to the clavicle was confirmed as being the herniating apex of the left lung.
A literature search found only one paper1 that describes a similar infant.
The child’s parents have consented to the publication of this article.