Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Decreased heart sound in a healthy newborn: Spontaneous multiseptated cystic pneumomediastinum with delayed respiratory distress

자발성 종격동 기흉: 작게 청진된 심음을 주소로 내원한 신생아

  • Choe, Young June (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Eun Sun (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Ee-Kyung (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Han-Suk (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Chun, Jung-Eun (Department of Radiology, Seoul National University College of Medicine) ;
  • Kim, Woo Sun (Department of Radiology, Seoul National University College of Medicine) ;
  • Kim, In-One (Department of Radiology, Seoul National University College of Medicine) ;
  • Choi, Jung-Hwan (Department of Pediatrics, Seoul National University College of Medicine)
  • 최영준 (서울대학교 의과대학 소아과학교실) ;
  • 김은선 (서울대학교 의과대학 소아과학교실) ;
  • 김이경 (서울대학교 의과대학 소아과학교실) ;
  • 김한석 (서울대학교 의과대학 소아과학교실) ;
  • 천정은 (서울대학교 의과대학 영상의학교실) ;
  • 김우선 (서울대학교 의과대학 영상의학교실) ;
  • 김인원 (서울대학교 의과대학 영상의학교실) ;
  • 최중환 (서울대학교 의과대학 소아과학교실)
  • Received : 2009.06.10
  • Accepted : 2009.10.21
  • Published : 2010.02.15
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Abstract

Spontaneous pneumomediastinum in the absence of predisposing risk factors has been rarely observed in full-term neonates. A 3-day-old neonate, delivered vaginally at term without any perinatal complications or signs of respiratory difficulty, was referred to the Seoul National University Children's Hospital because of reduced heart sound detected during routine neonatal examination. Chest computed tomography (CT) showed air collection in the anterior mediastinum. The baby developed respiratory distress on the fourth day and required supplemental oxygen. On the seventh day, there was no sign of respiratory difficulty, and x-ray examination showed no demonstrable pneumomediastinum. Hence, careful neonatal physical examination is essential during the postnatal assessment of newborns, and spontaneous pneumomediastinum should be considered when a healthy newborn presents with reduced heart sound.

자발성 종격동 기흉은 신생아기에 발생하는 호흡곤란의 드문 원인 중의 하나이며 대부분의 증례에서는 인공호흡, 출산손상, 태변흡입 등이 선행하는 경우가 많으며, 또한 대다수가 미숙아로 알려져있다. 저자들은 신생아 진찰 중 심음이 적게 들리는 소견으로 발견되었던, 위와 같은 위험인자가 없는 건강한 만삭아에서 발생한 자발성 종격동 기흉 1예를 경험하였기에 이를 보고하는 바이다.

Keywords

References

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