Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI, 49503, USA.
Interventional Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA.
Pediatr Radiol. 2020 Oct;50(11):1624-1628. doi: 10.1007/s00247-020-04712-2. Epub 2020 Jun 20.
A 23.4-week premature and extremely low birth weight neonate was transferred to the Neonatal Intensive Care Unit for management of respiratory failure and retrocardiac pneumomediastinum, suspected to be the result of a low tracheal injury during intubation. Initial conservative management failed and chest radiographs demonstrated worsening retrocardiac pneumomediastinum. Due to the patient's extreme low birth weight and location of the pneumomediastinum, surgery was deemed to be very high risk and potentially fatal. We report the successful definitive percutaneous management of retrocardiac tension pneumomediastinum with a minimally invasive bedside method using an intercostal paraspinal approach under the guidance of ultrasound and plain radiography.
一名 23.4 周早产且极低出生体重的新生儿因呼吸衰竭和心脏后纵膈气肿转入新生儿重症监护病房，疑似在插管过程中发生了低位气管损伤。最初的保守治疗失败，胸部 X 光片显示心脏后纵膈气肿加重。由于患儿极低的出生体重和纵膈气肿的位置，手术被认为风险极高，可能导致致命。我们报告了在超声和 X 线引导下，采用肋间旁脊柱入路的微创床边方法，成功地对心脏后张力性纵膈气肿进行了经皮治疗。
