Mendelson syndrome or peptic pneumonia refers to acute chemical pneumonitis caused by the aspiration of stomach contents in patients under general anesthesia.
This syndrome develops rapidly (2-12 hours after aspiration) and within hours the patient may become
Other signs include
- bronchospasm with need for increasing ventilation pressure
- bronchial hypersecretion
- pulmonary vasoconstriction
Usually there is minimal sputum production ref needed.
The primary pathogenesis is secondary to the aspiration of acidic stomach contents, although other compounds, e.g. bile, may also play a role.
The chemical burns and causes occlusion of bronchi and bronchioles damaging the epithelium typically leading to pulmonary edema (ARDS). Secondary bacterial superinfection (aspiration pneumonia) may develop.
Plain film and CT may depict fleeting infiltrates (which do not last more than 1 or 2 days), atelectasis and non-cardiac lung edema.
History and etymology
It is named after the American anesthesiologist Curtis L Mendelson, who described it in 1946 2.
- 1. Parker MS, Christenson ML, Abbott GF. Teaching atlas of chest imaging. Thieme Medical Pub. (2005) ISBN:1588902307. Read it at Google Books - Find it at Amazon
- 2. MENDELSON CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am. J. Obstet. Gynecol. 2010;52: 191-205. Pubmed citation