Aspiration bronchiolitis

Last revised by Joshua Yap on 9 Sep 2022

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

Patients with esophageal conditions such as achalasiaZenker diverticulum, or esophageal carcinoma are at risk for aspiration bronchiolitis.

  • neurologic disorders: ~ 50% 3
  • dementia: ~50% 3

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 characterized by a chronic inflammatory reaction to repeatedly aspirated foreign particles in the bronchioles.

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

Consolidation is not a major radiological finding.

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

Diffuse aspiration bronchiolitis as distinct entity was thought to have been first proposed by T Mastuse et al. in 1996 3.

If features are diffuse consider:

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

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