IMAGE OF THE WEEK

WEEK 6

MECONIUM ASPIRATION SYNDROME

The first intestinal discharge from newborns is meconium, which is a viscous, dark-green substance composed of intestinal epithelial cells, lanugo, mucus, and intestinal secretions. Intestinal secretions, mucosal cells, and solid elements of swallowed amniotic fluid. Meconium is sterile and does not contain bacteria, the primary factor that differentiates it from stool.

Meconium aspiration syndrome involves aspiration of meconium through the trachea into the bronchial tree, sometimes down to the level of the alveoli.

It is associated with foetal distress in full term infants

Radiographic Features

In addition to obstruction of the airway, the aspiration leads to an inflammatory response in the lung parenchyma and it is this inflammation, not the meconium itself that results in the ill defined infiltrates on chest x-ray.

Bilateral diffuse infiltrative changes are characteristic.

The lungs may be hyperinflated due to air trapping. 

May have an associated pneumothorax or pneumomediastinum

Pleural effusion is uncommon (10%)

The lungs may be hyperinflated

Usually resolves rapidly (within a couple of days)

Images prepared by Dr Ian Bickle, Consultant Radiologist, RIPAS Hospital, Brunei Darussalam.

All images are copyrighted and property of RIPAS Hospital.