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Radiological Case of the Month

Lionel W. Young, MD; James E. Crowe, MD; Thomas E. Sumner, MD
Am J Dis Child. 1978;132(8):813-814. doi:10.1001/archpedi.1978.02120330085019.
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Cinical History.—A newborn infant boy had respiratory distress that began immediately after birth.

Physical Examination.—He weighed 1,910 g, was tachypneic, with intercostal retractions and grunting, and had a slightly scaphoid abdomen. Combined chest and abdominal roentgenograms were obtained (Fig 1 and 2).

Denouement and Discussion 

Split Notochord Syndrome  The vertebral anomalies of anterior and posterior spina bifida are often accompanied by a characteristic complex of visceral and neural abnormalities. One of the embryologic explanations for this combination of anterior and posterior spina bifida is the "split notochord" theory. This theory proposes that a primitive node cell rest persiiists in the midline, producing a notochordal cleft that causes the vertebral centra to be laid down in independent halves.1The most common visceral anomalies present in infants and children with the split notochord syndrome are mediastinal cysts of foregut origin (neurenteric cysts) and enteric duplications, most of which arise from the small


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