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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
05:50

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Published on: March 12, 2020

Breast deformity in adolescence as a result of pneumothorax drainage during neonatal intensive care

Christian Rainer1, Alexander Gardetto, Martin Frühwirth

  • 1Department of Plastic and Reconstructive Surgery, University of Innsbruck and Ludwig-Boltzmann Institute for Quality Control in Plastic Surgery, Innsbruck, Austria. christian.rainer@chello.at

Pediatrics
|January 2, 2003
PubMed

Insights

Neonatal pneumothorax treatment can cause breast deformities in females. Anatomical guidance for chest drain placement can prevent this iatrogenic damage and subsequent psychological distress in adolescent girls.

Area of Science:

  • Neonatal intensive care
  • Pediatric surgery
  • Anatomy

Background:

  • Invasive procedures like chest drain insertion are critical for neonatal resuscitation.
  • A narrow safety margin exists between therapeutic effectiveness and iatrogenic injury in neonates.
  • Female neonates are susceptible to specific iatrogenic damage, such as breast deformity, following pneumothorax treatment.

Observation:

  • Two female patients born prematurely developed breast deformities after multiple pneumothorax drainages during neonatal intensive care.
  • Anatomical dissection of 5 newborn female cadavers revealed breast tissue extending from the 2nd/3rd rib to the 6th rib vertically.
  • Breast tissue extended from the sternal edge to the anterior axillary line laterally.

Findings:

  • Neonatal breast tissue anatomy is more extensive than previously recognized.
  • Chest drain placement during neonatal pneumothorax treatment can inadvertently damage breast tissue.
  • Iatrogenic breast deformity can lead to significant psychological distress and necessitate corrective surgery in adolescence.

Implications:

  • Anatomically informed chest drain placement can prevent iatrogenic breast deformities in female neonates.
  • Specific recommendations include skin incision at the anterior axillary line, 4-5 cm inferior to the nipple.
  • Chest drain insertion via the 5th or 6th intercostal space is advised to avoid breast tissue injury.
Abstract

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