Acute aspiration pneumonitis

Case contributed by Dr Yair Glick

Presentation

Status post-colonoscopyץ Saturation ~80% with oxygen by nasal cannula.

Patient Data

Age: 70 years
Gender: Female
X-ray

Patchy alveolar infiltrates in all zones of the left lung, more prominent in the lower zone.

Surgical clips in right upper abdomen indicating cholecystectomy (known).

Additional surgical clips at midline at level of T11.

CT

Abdominal CT to rule out free abdominal air performed several hours after radiography. Upper slices shown.

Patchy confluent consolidation in lingula and left lower lobe (LLL) with air bronchograms.

X-ray

Follow-up radiograph taken 5 days later:

Resolution of all but the lingular infiltrates. Linear atelectasis at base of the left lung.

Case Discussion

Status post-follow-up colonoscopy for polyps following right hemicolectomy due to colon cancer. The patient suffered from malaise, shivers, abdominal pain, vomiting, and a feeling of unease. She was haemodynamically stable, but her saturation was ~80% with nasal cannula. The patient refused to receive oxygen by mask.

The initial chest radiograph taken on admission shows patchy alveolar infiltrates in the left lung, most consistent with aspiration of stomach contents during colonoscopy due to sedation.

The follow-up radiograph taken 5 days later shows partial resolution, with infiltrates remaining only in the lingula.

 

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Case information

rID: 53647
Case created: 29th May 2017
Last edited: 2nd Jun 2017
System: Chest
Inclusion in quiz mode: Included

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