Reşit KÖKEN, Ayşegül BÜKÜLMEZ, Ömer DOĞRU, Hamide MELEK, Osman ÖZTEKİN

Pulmoner interstisyel amfizem: İki olgu

Amaç: Alveoler ve küçük hava yollarının rüptürü sonucu havanın perivasküler adventisya içinde birikmesi ve interstisyumda toplanması Pulmoner İnterstisyel Amfizem (PİA) olarak tanımlanır. Mekanik ventilatör desteği alan preterm yenidoğanlarda daha sık görülen PİA’da mortalite % 50’nin üzerindedir. Olgu sunumu: İlk olgumuz preterm yenidoğan olup mekanik ventilatör desteği kesildikten sonra satürasyon düşüklükleri olması nedeniyle çekilen PA akciğer grafisinde interstisyel çizgilenmeler, mediastende sola kayma ve sol akciğerde bası görünümü vardı. İkinci olgumuz ise term yenidoğan olup mekanik ventilatör desteği verilirken çekilen PA akciğer grafisinde; sol akciğerde pnömatosel, sağ akciğerde yaygın interstisyel çizgilenmeler ve havalama artışı vardı. Her iki olgumuzun PA akciğer bulguları PİA ile uyumlu olarak değerlendirildi. İlk olgumuz iyi durumda taburcu edilirken, ikinci olgumuz intraventriküler kanama gelişmesi nedeniyle kaybedildi. Sonuç: Mekanik ventilatör desteği alan bebeklerde ortaya çıkan solunum problemlerinde mortalite ve morbiditesi yüksek olan PİA akıldan çıkarılmamalıdır.

Pulmonary interstitial emphysema: Two cases

Objective: Pulmonary interstitial emphysema (PIE) is described as the air accumulation in interstitium and perivascular adventitia resulted from the rupture of alveolar and small airways. PIE has a mortality rate higher than 50 % and was more frequently seen in preterm newborns who are taking mechanical ventilatory support. Case report: Our first case is a preterm newborn, whose PA chest x-ray that was taken because of saturation decreases after the cessation of mechanical ventilator support, showed interstitial striation, mediastinal shift to the left, and a compressed image of left lung. In the PA chest x-ray of our second case that was acquired during the mechanical ventilatory support, presented pneumatocele in the left lung and disseminated striations and hyperaeration in the right lung. Chest x-ray findings of both cases were found compatible with PIE. First patient was discharged as healthy, however, the second patient died because of intraventricular hemorrhage. Conclusion: PIE which has high mortality and morbidity rates should be kept in mind in newborns with respiratory disabilities who take mechanical ventilatory support.

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