Meconium Aspiration Syndrome

Etiology: Post-term neonate who passes meconium in utero due to fetal distress, fetal distress then leads to fetal gasping and aspiration of amniotic fluid containing meconium, which results in chemical pneumonitis and airway obstruction
Imaging CXR: Increased lung volumes (hyperinflation) and coarse interstitial infiltrates
DDX:
Complications:
— Airleak (pneumothorax and pneumomediastinum) from airway obstruction
— Persistent fetal circulation (persistent pulmonary hypertension) due to no decrease in peripheral vascular resistance
Treatment:
Clinical: Diagnosis made during intubation when meconium is noted beneath vocal cords

Radiology Cases of Meconium Aspiration Syndrome

CXR of meconium aspiration syndrome — CXR AP shows bilateral thick and coarse interstitial infiltrates in bilaterally hyperexpanded lungs.

CXR of meconium aspiration syndrome — CXR AP shows thick and coarse interstitial infiltrates bilaterally in hyperexpanded lungs. The tip of the umbilical venous catheter is in the right atrium.

CXR of meconium aspiration — CXR AP shows thick and coarse interstitial infiltrates bilaterally in hyperexpanded lungs. There is a small right apical pneumothorax.

CXR of meconium aspiration syndrome — Initial CXR shows increased lung volumes and coarse interstitial infiltrates.

CXR of a highly positioned endotracheal tube in a patient with meconium aspiration syndrome — CXR AP shows the tip of the endotracheal tube to be above the thoracic inlet. The lungs are hyperinflated and there are coarse interstitial infiltrates bilaterally.

CXR of meconium aspiration syndrome — CXR AP shows a hyperinflated chest with coarse interstitial infiltrates.