LAUSR

A newborn was delivered via cesarian section from a mother without any relevant medical history. At birth, paradoxical movement of the upper part of the left hemithorax was noted (Fig. 1). Initially, birth trauma was suspected. A chest X-ray was performed showing dextrocardia without rib-cage abnormalities (Fig. 2a). Physical examination was also relevant for hypoplastic nipple and soft tissue in the left hemithorax and absence of signs of respiratory difficulty (Fig. 2b). Poland’s syndrome is a rare congenital condition characterized by the absence of a unilateral pectoralis major. It can be associated with many other malformations, which are usually ipsilateral to the side of presentation. It may include absence or hypoplasia of the ribs, breast tissue, nipple, or subcutaneous tissue and malformation of digits as syndactyly or brachydactyly. Dextrocardia is also seen in a few cases when left side of the thorax is affected. The etiology of this syndrome remains uncertain, but the hypothesis that it is due to an in utero vascular flow impairment is widely accepted. Paradoxical breathing is usually secondary to chest trauma and may be seen in severe cases of obstructive sleep apnea and neuromuscular disorders such as Guillain Barr e syndrome, multiple sclerosis, or muscle dystrophy disorders. The etiology of Poland’s syndrome is not listed as an etiology of paradoxical breathing, but was described in a few cases in the literature. The presentation may be secondary to the absence of cartilage structures in the ribs plus absence of soft tissue which may manifest as lung herniation or paradoxical breathing as in our case. Manifestations of Poland’s syndrome in newborns