Journal Information
Vol. 46. Issue 12.
Pages 729-730 (December 2022)
Vol. 46. Issue 12.
Pages 729-730 (December 2022)
Images in Intensive Medicine
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Diagnosis of pneumothorax, non-visualized in post-anterior chest radiography, by pulmonary ultrasound
Diagnóstico de neumotórax, no visualizado en radiografía posteroanterior de tórax, mediante ecografía pulmonar
P. Morales-Arandojo
Corresponding author
, D. Gónzález-Diego, A. Alonso-Ojembarrena
Servicio de Neonatología, Hospital Universitario Puerta del Mar, Cádiz, Spain
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This is the case of a new-born baby who, in his 10th minute of life, starts showing signs of respiratory distress that decreases after admission to the neonatology unit after the administration of oxygen therapy through nasal cannula. Physical examination: bilateral hypoventilation without any other pathological findings. Posterior-anterior chest x-ray is performed without any pathological findings being reported (Fig. 1), which is why it was decided to perform a pulmonary ultrasound that reveals the presence of bilateral anterior pneumothorax (Fig. 2). The ultrasound shows no lung sliding with lung point sign in B mode in the anterior axillary line and the «bar code» or «stratosphere» sign in M mode (arrow) suggestive of no lung sliding. For educational reasons, it was decided to perform a lateral chest x-ray with horizontal beam lateral view, and the finding was confirmed (Fig. 3, black arrow). Patient progression was good and oxygen therapy was removed 2 days after admission. Since then, serial ultrasound follow-ups have been conducted that have confirmed the spontaneous resolution of the disease.

Figure 1.

Posterior-anterior chest x-ray. No radiographic signs of pneumothorax found.

Figure 2.

Lung ultrasound in M mode. “Bar code”, “stratosphere” or «seashore» sign.

Figure 3.

Lateral chest x-ray with horizontal beam. Bilateral anterior pneumothorax.

Copyright © 2020. Elsevier España, S.L.U. and SEMICYUC
Medicina Intensiva (English Edition)
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