CASE 33 A term newborn presented with respiratory distress at birth and meconium-stained fluid. Frontal (Fig. 33A) and lateral (Fig. 33B) radiographs of a term newborn with meconium aspiration syndrome reveals bilateral combined multifocal air space, and nodular and interstitial disease in large volume lungs. The radiographs show diffuse hyperinflation and patchy areas of mixed emphysema and atelectasis, with symmetric or asymmetric bilateral nodular infiltrates. Note the moderate-sized left tension pneumothorax (manifestation of air-block phenomenon). This is commonly seen secondary to the requirement for pressure ventilation in a child with significant large and small airway obstruction by the meconium plugs (Fig. 33A). Meconium aspiration syndrome
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