Premature newborn with respiratory distress on a ventilator

CXR of pneumomediastinum
CXR AP+lateral shows air around the thymus superiorly and air around the heart inferiorly. The diaphragm can be traced continuously across both images. There is also a small amount of air in the apex of the right pleural space.

The diagnosis was pneumomediastinum and a small right apical pneumothorax in a patient with respiratory distress syndrome.