Pulmonary Interstitial Emphysema (PIE) Clinical Presentation

  • Author: Abhay J Bhatt, MD, MBBS; Chief Editor: Ted Rosenkrantz, MD   more...
 
Updated: Jun 8, 2011
 

History

Pulmonary interstitial emphysema (PIE) is a radiographic and pathologic diagnosis. In most cases, the discovery of pulmonary interstitial emphysema may be preceded by a decline in the baby's clinical condition. Hypotension and difficulty in oxygenation and ventilation can suggest the development of pulmonary interstitial emphysema.

Alternatively, the baby can present with the signs of one of the complications of pulmonary interstitial emphysema, such as pneumothorax. Sometimes, pulmonary interstitial emphysema becomes apparent following reexpansion of a collapsed lung after drainage of a pneumothorax.

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Physical Examination

No specific signs of pulmonary interstitial emphysema are reported. Overinflation of the chest wall and crepitations on auscultation on the affected side may be present.

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Complications

Potential complications of pulmonary interstitial emphysema include the following:

  • Respiratory insufficiency
  • Other air leaks (eg, pneumomediastinum, pneumothorax, pneumopericardium, pneumoperitoneum, subcutaneous emphysema [rare])
  • Massive air embolism
  • Chronic lung disease of prematurity
  • Intraventricular hemorrhage
  • Periventricular leukomalacia
  • Death
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Contributor Information and Disclosures
Author

Abhay J Bhatt, MD, MBBS  Associate Professor, Department of Pediatrics, Division of Newborn Medicine, University of Mississippi Medical Center

Abhay J Bhatt, MD, MBBS is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Coauthor(s)

Rita M Ryan, MD  Professor of Pediatrics, Chief, Division of Neonatology, Director, Neonatal-Perinatal Medicine Fellowship Program, University of Buffalo State University of New York School of Medicine and Biomedical Sciences, Women's and Children's Hospital of Buffalo

Rita M Ryan, MD is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Brian S Carter, MD, FAAP  Professor of Pediatrics (Neonatology), Vanderbilt University School of Medicine; Director, Neonatal Follow-up Program, Monroe Carell Jr Children's Hospital at Vanderbilt

Brian S Carter, MD, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Society for Bioethics and Humanities, American Society of Law, Medicine & Ethics, National Hospice and Palliative Care Organization, Society for Pediatric Research, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Ted Rosenkrantz, MD  Professor, Departments of Pediatrics and Obstetrics/Gynecology, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine

Ted Rosenkrantz, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Pediatric Society, Connecticut State Medical Society, Eastern Society for Pediatric Research, and Society for Pediatric Research

Disclosure: Nothing to disclose.

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This radiograph, obtained from a 1-day-old premature infant at 24 weeks' gestation, shows bilateral pulmonary interstitial emphysema (PIE). Linear radiolucencies extending up to the lung periphery are visible.
This radiograph, obtained from a premature infant at 26 weeks' gestation, shows characteristic radiographic changes of pulmonary interstitial emphysema (PIE) of the right lung.
This radiograph shows pneumothorax and pulmonary interstitial emphysema (PIE) on the right side. Interstitial air prevents collapse of the underlying lung by a tension pneumothorax. In such cases, extreme caution is required during drainage of a pneumothorax to avoid perforation of the underlying lung.
 
 
 
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