Barium bronchogram from aspiration

Discussion:

An impressive illustration of the bronchial anatomy of the left lower lobe to at least the subsegmental level.

Couple of practical practising points with barium swallows:

1. Ask the patient when they drink does it ever go down the wrong way'?

2. If in any doubt do a test swallow/sip with water-soluble contrast 

3. If they do aspirate ensure the patient gets immediate chest physiotherapy.

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