Pulmonary Interstitial Emphysema Clinical Presentation

Updated: Jan 04, 2016
  • Author: Abhay J Bhatt, MD, MBBS; Chief Editor: Ted Rosenkrantz, MD  more...
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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.


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.



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