Neonatal Abdominal Radiograph Reveals Curvilinear Lucency

Abstract

A preterm, small-for-gestational-age male newborn (36 weeks; 1600 grams; < 3rd percentile) infant in our neonatal intensive care unit was diagnosed with early-onset hypoglycemia. Therefore, soon after birth, he was initiated on gavage feedings. The rising glucose infusion concentrations necessitated the placement of an umbilical venous line. At 48 hours of life, coffee-colored aspirates emerged, mimicking the initial stages of necrotizing enterocolitis. However, a soft abdomen on palpation, audible bowel sounds, and frequent meconium passages were reassuring. An abdominal radiograph obtained to assess the placement of the umbilical venous catheter revealed a curvilinear lucency, raising clinical suspicion of a serious ailment. The infant was kept nil per os; parenteral nutrition was started. A repeat X-ray and an ultrasound taken 24 hours after the initial examination suggested that the air collection was resolving. Soon, the aspirates cleared, and oral feeding was initiated. The infant was discharged in good health after two weeks. At a follow-up visit four months after birth, he was thriving and growing well. Informed consent was taken from the patient's mother.

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