Page 372 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-005
Prediction of Gap Length in Esophageal Atresia by Chest Radiograph
with Orogastric Tube: A Case Report

Adhini Dwirespati , Naela Fadhila , Evita Karianni 2
2
1
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
1
2
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Esophageal atresia is a congenital anomaly in which there is interruption of the esophageal
lumen resulting in an upper and lower segment. The worldwide prevalence of esophageal atresia is 1 in
2400-4500 newborns and contribute to neonatal and infant morbidity and mortality. The earliest clinical sign
of an infant with esophageal atresia (EA) is polyhydramnios resulting from the infant's inability to swallow
and absorb amniotic fluid through the gut. Conventional barium esophagography is the gold standard for
diagnosing esophageal fistula. Gap between the esophageal pouches plays a major role in determining the ease
and feasibility of a primary repair. Higher gap length was associated with increased need for postoperative
ventilation and poor outcome. Objective To show how to predict the length of gap esophageal atresia based on
the lowest position of the proximal esophageal pouch. Case A male infant (38 weeks, 2400 grams), antenatal
ultrasound examination showed polyhydramnions and orogastric tube (OGT) was unable to pass into the
stomach. Chest radiograph was performed after the insertion of OGT that filled with contrast material before
and showed the OGT curved at 2nd thoracic spine. Conclusion A plain radiograph done with a catheter in
situ can provide useful information regarding the level of upper pouch of esophageal atresia.
Keywords: esophageal atresia (EA); chest radiograph; orogastric tube

P-PI-006
Lung Ultrasound for the Diagnosis of Neonatal Pneumonia

Nur Laila Fitriati Ahwanah , Naela Fadhila , Evita Karianni Bermanshah 2
2
1
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
2
1
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Pneumonia affects approximately 1% term and at least 10% preterm infants. Early recognition
and prompt treatment will reduce morbidity and mortality. Lung ultrasound (LUS) is increasingly being
used for evaluating neonatal pneumonia. Objective To demonstrate the role of LUS for diagnosing neonatal
pneumonia. Cases Case 1: A preterm neonate (31 weeks, 1540 grams) was born prematurely because her
mother had continuous bleeding caused by placenta previa, steroid had already given. Patient born with
shortness of breath suspected as respiratory distress syndrome. She was given non-invasive positive pressure
ventilation, but there was no improvement. The 1st dose of surfactant was given and chest X-ray (CXR) was
performed in an hour. We found right pulmonary infiltrate showing pneumonia. While in LUS we found shred
sign, dynamic air bronchograms, and irregular pleural line confirming pneumonia. Case 2: A preterm neonate
(25 weeks, 720 grams) was born prematurely because his mother had regular contraction and bloody show,
steroid had already given. Patient born with no spontaneous breathing, so intubation was performed. The 1st
dose of surfactant was given. Due to worsening breathlessness, he used high frequency oscillation (HFO)
in 3 days old. After 2 weeks, he had desaturation with HFO. CXR showed bilateral pneumonia and upper
right lobe atelectasis. From LUS, we found irregular pleural line, shred sign, and dynamic air bronchograms
showing pneumonia. Conclusion LUS is a fast, easy, reproducible, bed-side, no radiation exposure, and
more available than mobile CXR. It is useful for the diagnosis of neonatal pneumonia.
Keywords: lung ultrasound; pneumonia; neonate

324 KONIKA XVIII Abstract Book