Neonatal pneumothoraces with atypical location: the role of lung ultrasound

Neonatal pneumothorax (NP) is a potentially life-threatening condition. Lung ultrasound (LUS) has shown higher sensitivity and specificity in diagnosis compared to x-rays, but evidence regarding its usefulness in complex NP is lacking. We report four neonates suffering from cardiac or esophageal malformations who developed lateral and/or posterior pneumothoraces, in which LUS helped, making NP diagnosis and management easier and faster. Conclusion: LUS is an easy-to-use, fast, simple, and accurate tool when evaluating newborns with NP, also in atypical positions such as in surgical patients. What is Known: Lung ultrasound (LUS) has higher sensitivity and specificity than x-rays in the diagnosis of pneumothorax in neonatal patients. What is New: This is the first report about neonatal pneumothorax in non-conventional areas (lateral/posterior) diagnosed by lung ultrasound and how obtaining this information is critical in order to optimize management.