Pulmonary Interstitial Emphysema Clinical Presentation

Updated: Jun 25, 2019
  • Author: Abhay J Bhatt, MD, MBBS; Chief Editor: Muhammad Aslam, MD  more...
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History and Physical Examination


Pulmonary interstitial emphysema (PIE) is a radiographic and pathologic diagnosis. PIE is associated with few clinical signs, but a progressive, sometimes rapid, increase in oxygen (O2) requirements, carbon dioxide (CO2) retention or hypotension are suggestive of this diagnosis.

Alternatively, the infant can present with the signs of one of the complications of PIE, such as pneumothorax. Occasionally, PIE becomes apparent following reexpansion of a collapsed lung after drainage of a pneumothorax.

Physical examination

No specific signs of PIE are reported. There may be overinflation of the chest wall and crepitations on auscultation on the affected side. A characteristic sound of crushing styrofoam or walking on dry snow signals PIE.