Paediatric Imaging

Oedema, noncardiogenic

Pulmonary oedema may occur due to noncardiac causes. There is no cardiomegaly, but otherwise the pattern of interstitial and alveolar oedema may be indistinguishable (Fig.1). There is unlikely to be redistribution of blood flow and peribronchial cuffing may be absent.

Neurogenic pulmonary oedema may be seen following head injury, seizures or any sudden increase in intracranial pressure. Pulmonary oedema is seen in renal failure due to a combination of causes.There may be fluid retention, hypoproteinaemia and an increase in capillary permeability. Oedema may be seen secondary to acute upper airway obstruction in children. It is thought to be due to a sharp inspiration against a closed glottis causing an abnormal increase in intrathoracic pressure and disrupting the normal mechanism for clearance of pulmonary fluid by lymphatics. This is also thought to be the mechanism for the development of oedema following rapid re-expansion of a collapsed lung, due to pneumothorax or compression by pleural fluid. See oedema pulmonary

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Fig.1

2-year-old girl with meningococcal septicaemia. There is airspace shadowing due to alveolar oedema with air bronchograms visible at both bases.
Oedema, noncardiogenic, Fig.1