mendelson syndrome
Mendelson syndrome or peptic pneumonia refers to acute chemical pneumonitis caused by the aspiration of stomach contents in patients under general anesthesia.
Clinical presentation
This syndrome develops rapidly (2-12 hours after aspiration) and within hours the patient may become
- tachypneic
- hypoxic
- febrile
Other signs include
- bronchospasm with need for increasing ventilation pressure
- bronchial hypersecretion
- pulmonary vasoconstriction
- cyanosis
Usually there is minimal sputum production .
Pathology
The primary pathogenesis is secondary to the aspiration of acidic stomach contents, although other compounds, e.g. bile, may also play a role.
Pathogenesis
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.
Radiographic features
Plain film and CT may depict fleeting infiltrates (which do not last more than 1 or 2 days), atelectasis and non-cardiac lung edema.
Differential diagnosis
- cardiac failure
- amniotic fluid embolism
- in chronic state may mimic a lung mass
History and etymology
It is named after the American anesthesiologist Curtis L Mendelson, who described it in 1946 .
