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Case 21 : Film quiz : Caseเด็กอายุ7เดือน normal labour คลอดท่าbreech, term AGA with mild birth asphyxia.BW 3,190 gm มีภาวะ meconium aspiration ให้ ATB เป็น ampicillin + gentamicin (5 วัน), clafloran + amikin (5 วัน) imipenam+amikin (14 วัน) on ET tube with ventilator 4 วัน
ผศ.พญ.อาภัสสร วัฒนาศรมศิริ
Panruethai Trinavarat,M.D.
Assistant Professor.
Department of radiology,
Case 21 :
Film quiz :
Caseเด็กอายุ7เดือน normal labour คลอดท่าbreech, term AGA with mild birth asphyxia.BW 3,190 gm มีภาวะ meconium aspiration ให้ ATB เป็น ampicillin + gentamicin (5 วัน), clafloran + amikin (5 วัน) imipenam+amikin (14 วัน) on ET tube with ventilator 4 วัน
Findings:
CXR finding
Blurring of the images decrease image quality. This is rather from motion during using digital camera rather than suboptimal imaging technique.
- Cystic lesions are noted in left lower chest, likely from high position of bowel loops. There is contralateral mediastinal shift, which is more exaggerate by mild rotatation of patient slightly to the right in AP view.
- The left hemidiaphragm is not well seen in AP view, probable from blurring of the image or diaphragmatic defect!, but from left lateral view, the left hemidiaphragm seems to be intact and much elevated.
- So the findings are suggestive of eventration (membranous thinning) of the left hemidiaphragm, rather than diaphragmatic hernia or cystic lung disease.
