Pulmonary interstitial emphysema after resolution of relapsing pneumothorax and discontinuation of mechanical ventilation. An atypical case in a preterm infant

Pulmonary interstitial emphysema (PIE) is a frequent complication in preterm-ventilated infants. These newborns have an increased risk of mortality and bronchopulmonary dysplasia. Various treatments for PIE have been proposed: high-frequency ventilation, postural therapy, selective bronchial intubation or surgery. We present an atypical case of a preterm infant with respiratory distress syndrome complicated by pneumothorax, who after recovery and discontinuation of mechanical ventilation, developed unilateral PIE which was treated with selective bronchial intubation. Conclusions: Selective bronchial intubation and lung ventilation are therapeutic strategies which can promote the regression of PIE. Conservative approach should remain the first choice treatment of unilateral PIE in order to limit surgical procedures, while effort should be made to prevent this iatrogenic complication.