Enfisema pulmonar intersticial persistente en recién nacido. Caso clínico

Abstract

Persistent Interstitial Pulmonary Emphysema (PIPE) is a syndrome characterized by air leak to the perivascular tissue in the lung, affecting newborns with history of mechanical ventilation. It is also characterized by lack of reabsorption of air in the gap in some areas and giant cell formation. Case Report: A 35-week preterm newborn is presented. Moan and retraction were observed, with oxygen requirements. At the hospital, the diagnosis of transient respiratory distress syndrome was done, requiring nasal CPAP support. At 12 hours of life a sudden clinical deterioration was noted, and a tension pneumothorax of the right lung was confirmed. Pneumothorax was drained with chest tube and high frequency ventilation was initiated. A chest X-ray showed reexpansion of right lung and greater confluence baseline images suggesting bronchopneumonia. After discontinuing ventilatory support, 2 chest CT images show a persistent interstitial pulmonary emphysema in the right lung. Patient was discharged at 13 days of life. Discussion: PIPE is a syndrome that must be suspected within the differential diagnosis of cystic lung diseases in the newborn. Its identification allows the exclusion of similar entities, and avoid unnecessary surgeries since PIPE may lead to spontaneous resolution.