Page 379 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-018
The Difference of Radiologic Features between Congenital Pulmonary Airway
Malformation and Congenital Diaphragmatic Hernia: A Report of Two Cases

2
1
Hanna Khairat , Naela Fadhila , Evita Karianni 2
1
2
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Congenital pulmonary airway malformation (CPAM) is the most common of congenital lung
anomalies (30-40%) with one of its differential diagnoses is congenital diaphragmatic hernia (CDH) that
occurs in 1:4000. Misdiagnosis between CPAM and CDH is frequent and could potentially lead to unnecessary
and harmful interventions. Objective To report the difference of radiologic features between CPAM and
CDH. Cases We report two cases of 36 weeks gestational age neonates were born in Cipto Mangunkusumo
Hospital with respiratory distress. Both patients received active resuscitation. The first patient got non-invasive
positive-pressure ventilation, followed with intubation, while the second patient was immediately intubated.
The first patient’s thoracoabdominal X-ray showed a cystic lesion in the left lung pushing the heart into the
right chest cavity with the normal diaphragm which corresponded to CPAM. Chest computerized tomography
(CT) scan confirmed these findings as CPAM type 1. The second patient’s anteroposterior (AP) and lateral
thoracoabdominal X-ray showed the left hemithorax had been occupied by the loops of small, large bowel,
and stomach which prolapsed into the thoracic cavity through the posterolateral defect of the diaphragm.
The mediastinum and the heart deviated to the contralateral right side, and the left diaphragm could not be
visualized. These findings were in accordance with Bochdalek hernia. Conclusion The presence or absence
of diaphragm on the chest X-ray can differentiate between CPAM and CDH.
Keywords: congenital pulmonary airway malformation (CPAM); congenital diaphragmatic hernia;
chest X-ray

P-PI-019
The Role of Lung Ultrasound as an Alternating Examination
for Hyaline Membrane Disease: A Case Report

Imyadelna Ibma , Evita Bermanshah Ifran , Haryanti Fauzia Wulandari 2
2
1
2
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
1
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Neonatal respiratory distress syndrome (RDS) also known as hyaline membrane disease is
one of the most common causes of neonatal respiratory failure and neonatal mortality in premature infants.
The current diagnostic reference standard includes clinical manifestation and chest radiography with
associated exposure to ionising radiation. Lung ultrasound is typically not included in diagnostic work-up
for HMD. Recently, ultrasound has been used extensively and successfully in the diagnosis of lung disease.
Objective To introduce that lung ultrasound as an alternative imaging modality to diagnose HMD.
Case The baby girl was born at 28th week gestation with birth weight of 1000 gram by C-section. The APGAR
score was 6 and 8 at 1 and 5 min respectively, the patient had active resuscitation and was intubated. The
patient got surfactant administration via endotracheal tube. After the surfactant administration, she went for
the chest X-ray and we found a reticulogranular pattern with air bronchogram accordance to HMD. On the
2nd day of life she went for her second surfactant administration and got extubated, but still need a continues
positive airway pressure (CPAP). We performed a lung ultrasound to evaluate the lung condition and we
still found HMD appearance. Conclusion The strength of lung ultrasound that lung ultrasound can be done
bedside, non-ionizing, low cost, easy to operate, fast and real-time. Lung ultrasound may be considered as
an alternative methods for diagnosis and evaluating treatment of HMD.
Keywords: HMD; lung ultrasound; chest X-ray

KONIKA XVIII Abstract Book 331