Pulmonary interstitial emphysema

  • Etiology: barotrauma from mechanical ventilation in patients with respiratory distress syndrome
  • Imaging: see rupture of alveoli with air leaking into interstitium, lymphatics, venous system
  • DDX: Pulmonary interstitial emphysema vs. airbronchograms of respiratory distress syndrome – both branch but pulmonary interstitial emphysema is thicker + blacker without orderly tapering of air bronchograms
  • Complications: prelude for pneumothorax, often tension pneumothorax

Cases of Pulmonary Interstitial Emphysema

CXR of pneumothorax
Supine CXR shows a large amount of air in the right pleural space with inversion of the right hemidiaphragm and mediastinal shift to the left. There is also evidence of pulmonary interstitial emphysema in the right lung.