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pediatric cases

Discussion in 'Spot Diagnosis' started by bb100, Mar 22, 2013.

  1. bb100

    bb100 Bronze Member

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    A chest X-ray film taken shortly after birth.
    diagnosis please

    [​IMG]
     

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  2. neo_star

    neo_star Moderator

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    Re: pediatric case

    i can see diffuse ground glass ( actually, granular ) opacity and an endotracheal tube. can't appreciate any air bronchograms ( may be the bronchii have not off-loaded the fluid yet )

    i go for neo-natal respiratory distress syndrome due to surfactant def.

    possible causes
    -prematurity
    -infant born to diabetic mother
     

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  3. amaniagz

    amaniagz Well-Known Member

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    I think the endotracheal tube is in the oesophagus.
     

  4. Nataly

    Nataly Young Member

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    fracture in clavicoacromial joint (we can see a free acromial end of clavicle).
    endotracheal tube is putten becase this fracture requires an operation.
     

    Last edited: Mar 23, 2013
  5. chrysso91

    chrysso91 Young Member

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    Trisomy 21 in newborn infants: 11 rib pairs; bell-shaped chest.
     

  6. dr_petroff73

    dr_petroff73 Young Member

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    I think so there is endotracheal tube is in the oesophagus - pneumoesophagis
     

  7. neo_star

    neo_star Moderator

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    no, the esophagus runs down on the left side and the ett is pointing to the right.

    2 possibilities

    1) the ett could be in the rt bronchus ( but it seems to be well above the carina )

    2) it could be slightly twisted

    in both cases the air entry will be preferentially into the right side.

    the differential air entry into either side ( left or right ) with the endo tracheal tube, above the carina, is courtesy the "Conada effect"

    For those who may be wondering about the "Conada Effect" - it just means than when a fluid moves past a curved surface it loves to caress it, creating a venturi like effect.

    [​IMG]

    I cud hav easily used another example, than this boring candle and jar...but U guys are free to imagine......

    Below is an illustration, showing diff. air entry into left side.




    [​IMG]

    So if withdrawing the ETT dosen't help, think of this possibility and try changing/correcting the axis of ETT.
     

  8. bb100

    bb100 Bronze Member

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    Correct Answer : surfactant deficiency disease (synonyms;Infant respiratory distress syndrome , hyaline membrane disease )
     

    Last edited: Mar 26, 2013

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