Fig. 1

Chest X-ray and CT scans of patient. A On admission: bilateral middle and lower zone air-space opacities; hyperlucency at the edge of mediastinum structures, suggestive of pneumomediastinum. B The axial CT scans at presentation: It shows diffuse bilateral opacities in bilateral lung, a pneumomediastinum, as well as minor subcutaneous emphysema in front of the sternum (yellow arrow). C The CT scan of bilateral middle and lower zones: it shows diffuse ground-glass opacity and extensive basal consolidation, a large pneumomediastinum as the air in the anterior and superior mediastinum (blue arrow) and a small left pneumothorax (red arrow). D Post-ECMO cannulation: X-ray of two-sided “White Lung” after ECMO performance. E Decannulation after 9 days of ECMO support: disappearance of pneumomediastinum and absorption of ground-glass opacities. F The corresponding axial CT scans after 29 days: it shows a reduction of the pulmonary inflammatory process and pneumomediastinum resorption. G The corresponding axial CT scans of C after 29 days: a marked reduction of pneumomediastinum and a complete resolution of pneumothorax is evident in the corresponding scan. A small glass opacity was shown in the medial segment of the right middle lobe