Spontaneous neonatal pneumomediastinum with spinnaker-sail sign: A case report

Neonatal pneumomediastinum is defined by the presence of free air within the mediastinum, usually associated with risk factors such as prematurity, meconium aspiration or neonatal resuscitation. Spontaneous pneumomediastinum is a rare condition in newborns. Chest radiography is crucial to the diagnosis and may demonstrate typical patterns, including the Spinnaker-sail sign. We report the case of a term male newborn delivered by uncomplicated vaginal delivery with no need for resuscitation. On day 2 of life, muffled heart sounds prompted echocardiographic evaluation, which was limited by marked interposed gas. Chest radiography subsequently demonstrated pneumomediastinum with the characteristic Spinnaker-sail sign. The newborn was admitted to the Neonatal Intensive Care Unit for monitoring and received low-flow oxygen. He presented a benign clinical course with complete resolution of the air leak by day 7 of hospitalization. This case highlights the importance of careful physical examination and recognition of radiographic patterns of pneumomediastinum in neonates to ensure appropriate diagnosis and management.