Presentation
Intubated for respiratory compromise.
Patient Data
Endotracheal tube at just above the carina, obstructing the left main bronchus.
Complete white out of the left hemithorax without mediastinal shift in keeping with left lung collapse.
Moderate right sided pneumothorax, with the deep sulcus sign.
NG tube tip in the stomach.
Endotracheal tube marginally retracted. NG tube tip in the stomach.
UAC tip at T6/T7 disc space. UVC tip at T11 level.
Interval right pleural drain. Pneumothorax almost completely resolved.
The left lung has re-expanded.
Case Discussion
The first radiograph has bilateral pathology causing respiratory compromise, which was quickly rectified by prompt medical intervention.
A right sided neonatal pneumothorax required intubation which temporarily inadvertently caused a contralateral left lung collapse due to the low endotracheal tube position.
Repositioning of the endotracheal tube and a pleural drain insertion lead to a much improved second radiograph just a few hours later.
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