Abstract
Pneumatoceles are air filled, thin-walled cystic lesions with in the lung parenchyma that occur infrequently in neonates and infants, often as a complication of positive pressure ventilation, air leak syndrome or ventilator associated pneumonia. Whilst majority of pneumatoceles regress spontaneously over days to weeks, few large pneumatoceles may lead to acute cardiorespiratory insufficiency and may require drainage under computerized tomography or fluoroscopic guidance. We present a case report of an unstable extreme preterm infant with a large pneumatocele and respiratory failure, that was treated successfully by drainage under bedside ultrasound guidance.