By Arnold J. Rudolph M.D., Arnold J. Rudolph MD
This can be a part of a extraordinary 5-volume set representing the existence paintings of the main meticulous photographic archivist in neonatology. Over the process forty years, Dr. Rudolph accrued images of almost each affliction, affliction, and affecting the child. jointly they act as a uniquely strong diagnostic instrument.
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Additional info for Atlas of the Newborn: Thorax, Abdomen, Blood, Endocrine, and Metabolic Disorders
This anomaly occurs as a result of a congenital foregut malformation. 58. 57 shows a single systemic artery to the left sequestered lobe and two arteries to the right sequestered lobe. 59. In this infant who presented with severe respiratory distress, a radiograph shows a right lower lobe infiltrate which is due to a pulmonary arteriovenous malformation. Congenital pulmonary arteriovenous fistulae may be single or multiple lesions. They present as homogenous densities of variable size and shape and are frequently in continuity with the hilar vascular shadows.
Clinical findings suggesting the diagnosis of pneumothorax include increasing respiratory distress, a unilateral chest bulge, diminished breath sounds on the affected side, and especially restlessness or irritability. If there is a large tension pneumothorax, there is decreased cardiac output and an elevated central venous pressure with profound circulatory collapse. In this radiograph there is a large left tension pneumothorax pushing the mediastinum and heart to the right. Note the marked depression of the diaphragm.
This may resolve spontaneously or may result in cardiac tamponade with muffled heart sounds and poor cardiac output. The pericardium is readily seen as a line of increased density between the air surrounding the heart and the air infiltrating the lung. 147. This infant on positive pressure ventilation developed a pneumothorax, pneumomediastinum, massive pneumopericardium, and subcutaneous emphysema in the neck, and especially on the left side of the chest. A massive pneumopericardium such as this always results in cardiac tamponade.