Aspiration bronchiolitis

Aspiration bronchiolitis, or diffuse aspiration bronchiolitis, is a condition characterised by a chronic inflammation of bronchioles caused by recurrent aspiration of foreign particles.

The onset of aspiration bronchiolitis can be more insidious than aspiration pneumonia, and in half of the patients, episodes of aspiration can be unrecognised 3. Patients may have a chronic cough.

It is characterised by a chronic inflammatory reaction to repeatedly aspirated foreign particles in the bronchioles. 

Patients with oesophageal conditions such as achalasia, Zenker diverticulum, or oesophageal carcinoma are at risk for aspiration bronchiolitis.

Associated conditions
  • neurologic disorders: ~ 50% 3
  • dementia: ~50 3
HRCT

Aspiration bronchiolitis may be seen as unilateral or bilateral foci of 1,6:

Consolidation is not a major radiologic finding.

A chronic cough in aspiration bronchiolitis usually does not respond to β-adrenergic bronchodilators or to inhaled steroids. The swallowing rehabilitation and temporally intravenous alimentation are considered the most effective way to reduce the symptoms 7.

If features are diffuse consider:

As a broader differential on CT, consider other forms of bronchiolitis.

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Article information

rID: 24311
System: Chest
Tag: cases
Synonyms or Alternate Spellings:
  • Diffuse aspiration bronchiolitis
  • Diffuse aspiration bronchiolitis (DAB)

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