Presentation
Bibasal crackles on auscultation in a patient with known head and neck cancer
Patient Data
Age: 85 years
Gender: Male
From the case:
Aspirated barium swallow
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No evidence of consolidation.
Note scattered radio-opaque markings bibasally.
Nasogastric tube in appropriate position for feeding.
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This is an older CT scan which also demonstrates the distribution of the barium - on bone window the aspirate is hyperdense in keeping with metal.
Case Discussion
Although there is no convincing evidence of infection on this plain film there are some interesting findings.
It shows the appropriate path for nasogastric feeding tubes and also evidence of previous tests related to a failed swallow with the aspirated barium.
Coupling the clinical history and previous imaging is especially useful in cases like this.