Pulmonary interstitial emphysema (PIE) is a well-described complication of positive-pressure mechanical ventilation and respiratory distress syndrome (RDS) in the newborn.' Although PIE is a common diagnosis in the neonatal intensive care unit (NICU), we are not aware of any reports documenting its presentation in an outpatient setting.2 We present a case of PIE in a former premature infant that occurred 1 month after extubation and 1 week after discharge with no subsequent evidence of respiratory distress until presentation. This patient suggests that PIE can have an insidious onset and that a delayed presentation of PIE should be included in the differential for respiratory distress in a former preterm infant recovering from severe RDS even after hospital discharge.

Congenital retropsoas small bowel herniation is reported as the cause of long-standing recurrent abdominal pain in a teenage girl. Knowledge of this entity is important for differential diagnosis of abdominal pain, mass, or retroperitoneal gas and fluid, and for avoiding complications of percutaneous renal interventions.

The combination of tracheoesophageal and pulmonary malformations is unusual and reportedly carries a high mortality. We have observed six patients with esophageal atresia and tracheoesophageal fistula and one with a bronchoesophageal fistula who had associated bronchopulmonary anomalies ranging from lobar hypoplasia and agenesis to unilateral pulmonary hypoplasia or agenesis. All of the pulmonary malformations were right-sided. Vertebral or rib anomalies were present in five patients, congenital heart disease in two, imperforate anus in one and one patient had radial aplasia and Pierre Robin syndrome. The bronchopulmonary anomalies complicated the surgical care of tracheoesophageal malformations and required radiologic differentiation from aspiration pneumonia and atelectasis. Six of the seven patients survived. Mortality and morbidity were related to complications and associated cardiac anomalies as well as severity of the lung anomaly.