Premature infant with respiratory distress on a ventilator

CXR of bilateral tension pneumothoraces and pneumomediastinum
CXR AP shows a large amount of lucency in the pleural spaces laterally and inferiorly to the right lung and superiorly and inferiorly to the left lung. There is air outlining the thymus and in the neck. The mediastinum remains in the midline.

The diagnosis was bilateral tension pneumothoraces and pneumomediastinum in a patient with respiratory distress syndrome.