Aspirationspneumonie

Intra- und
postdeglutitive Aspiration bei verminderter Larynx-Ventralbewegung (nicht abgebildet).
Wikipedia • CC BY-SA 4.0
Toddler with
respiratory distress after a surgical procedure that utilized general anesthesiaCXR AP shows a dense infiltrate in the apical aspect of the right upper lobe. The stomach is air-filled and distended.The diagnosis was aspiration pneumonia.
pediatricimaging.org • CC-by-nc-sa 4.0
Infant who is
often noted to gag and choke with feedingsCXR AP shows a dense infiltrate in the lateral aspect of the right upper lobe.The diagnosis was aspiration pneumonia.
pediatricimaging.org • CC-by-nc-sa 4.0
Preschooler
found face down in a swimming pool. CXR AP shows a normal sized heart and bilateral perihilar interstitial infiltrates. There is also a dense opacity in the right upper lobe.The diagnosis was pulmonary edema due to near drowning and probable aspiration pneumonia of the right upper lobe.
pediatricimaging.org • CC-by-nc-sa 4.0
Beyond
bronchitis: a review of the congenital and acquired abnormalities of the bronchus. Bronchiectasis due to recurrent aspiration. Axial CT imaging demonstrates sequela of chronic/recurrent aspiration with lower lobe-predominant bronchiectasis (solid arrows) and multiple ill-defined centrilobular and tree-in-bud nodules in the dependent portion of the right lower lobe (dashed arrows)
insightsimaging.springeropen.com • Open Access
Newborn with
choking while feeding. CXR (left) shows dextrocardia and diffuse lung infiltrates bilaterally. Oblique image from a pull-back esophagram performed with a nasogastric tube while injecting low-osmolar water soluble contrast in the distal esophagus (right) shows opacification of the trachea and bronchial tree via a fistula.The diagnosis was aspiration pneumonia due to esophageal atresia with H-type tracheo-esophageal fistula.
pediatricimaging.org • CC-by-nc-sa 4.0
Aspiration
pneumonia • Paraesophageal hernia with incarceration of the gastric antrum and duodenal bulb - Ganzer Fall bei Radiopaedia
Baba Y, Paraesophageal hernia with incarceration of the gastric antrum and duodenal bulb. Case study, Radiopaedia.org (Accessed on 05 Jun 2024) https://doi.org/10.53347/rID-161922 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

Aspiration pneumonia is caused by a direct chemical insult due to the entry of a foreign substance, solid or liquid, into the respiratory tract.

Epidemiology

Risk factors

Clinical presentation

Aspiration may be clinically silent, or it may present with dyspnea, cough, or fever. The clinical and radiographic features depend on the aspirated volume, pH, and chronicity .

Pathology

The aspirated particles act as a foreign body and induce granuloma formation .

Depending on the time course, patients may be classified as:

Radiographic features

The clinical and radiological manifestations are protean, varying from asymptomatic focal inflammatory reaction with few or no radiological abnormalities to severe life-threatening disease.​

The posterior segment of the upper lobes and the superior segment of the lower lobes are most commonly involved lung sites when aspiration occurs in a recumbent patient. In an erect patient, aspiration is more likely to involve bilateral basal segments, middle lobe, and lingula .

Aspirated low-density organic material such as mineral oil in the tracheobronchial tree or alveolar spaces cannot be diagnosed on plain radiographs but may be seen on CT. Opaque aspirates are also well demonstrated on CT.

See the articles below for more detailed radiological features depending on the time course:

Treatment and prognosis

Complications

The major complication associated with aspiration is pulmonary infection:

Differential diagnosis

Other causes of airspace opacity need to be considered :

See also

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Aspirationspneumonie:
akute
Aspirationspneumonie
pediatricimaging.org • CC-by-nc-sa 4.0
chronische
Aspirationspneumonie
insightsimaging.springeropen.com • Open Access