1. Pneumothorax & pneumopericardium

2. Pneumothorax, pneumopericardium pneumoperitoneum, subcut. emphysema

3. Pulmonary interstitial emphysema

4. CATHETER AND TUBE POSITION
1. ENDOTRACHEAL TUBE :
1 cm below vocal cord & 2 cm above carina
2. NASOGASTRIC TUBE : In stomach
3. UVC : in IVC or RA proper
4. UAC : in thoracic aorta below level of DA ( T4 )
and above origin of celiac artery ( T11 )

5. UAC at T3- 4 level

6. UAC tip is at T11

7. UVC tip is in portal vein

8. RESPIRATORY DISTRESS IN NEWBORN SURGICAL CAUSES
DIAPHRAGMATIC HERNIA
Common on left side
Multiple lucencies or cysts ( bowel loops ) in the chest
Shifting of heart and mediastinum to the other side
Decreased bowel gas or gasless abdomen

11. FOREIGN BODY ASPIRATION
Common in children years old
Tracheal obstruction
Bronchial obstruction
Incomplete - check valve : Air trapping
Complete : Atelectasis
S/S : Dyspnea, hyperpnea, cough,
+/- Hx of FB aspiration

12. F 11 mo , หายใจหอบหลังกินถั่วติดคอมา 1อาทิตย์

13. IiInInspiration film

14. Expiration film , more air trapping in right lung

15. Scope : peanut in Rt.main bronchus
Post F.B. removal film

16. F 4mo, cough, หายใจหอบหลังสำลักเม็ดส้มมา 1 wk

17. Post F.B.removal

18. Alimentary Tract Disease in Children

19. ALIMENTARY TRACT OBSTRUCTION IN NEWBORN
Normal abdominal bowel gas pattern : ‘Polygonal pattern’
Stomach : immediate after birth
Small bowel : within 3 hours
Colon : within 5 hours
Rectum : within 6-8 hours
Prone film to demonstrate air in rectum ( R/O obstruction )
Upright or left lateral decubitus film to demonstrate free air

20. Normal bowel pattern = polygonal

21. ESOPHAGEAL ATRESIA ( EA )
MC = proximal eso. atresia with distal TEF
High incidence of associated anomalies : VACTERL
( V-vertebral, A-anorectal , C-cardiovascular ,
TE-tracheoesophageal ,R-renal , L-limb )

24. GASTRIC OUTLET OBSTRUCTION IDIOPATHIC HYPERTROPHIC PYLORIC STENOSIS
S/S : Non-billous vomitting
Onset ~ 1 month old
Minimal upper abdominal distension
+/-palpable mass ( olive ) at epigastrium

25. IDIOPATHIC HYPERTROPHIC PYLORIC STENOSIS ( IHPS )
X-RAY FINDINGS :
Plain film : Gastric dilatation with large amount
of air/fluid content ,
Decreased small bowel gas
US : Elongation with thickening of muscle wall
of pyloric canal
UGI : Narrowing and elongation of pyloric canal ‘String
sign’
Muscle indentation on lumen of stomach and
duodenum ‘shoulder sign’

26. M 5 mo , vomiting for 5 d.