Barium Contrast Aspiration
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Parth Desai
An 82-year-old woman with type 2 diabetes mellitus was evaluated for aspiration pneumonia. She reported progressive dysphagia to solids and liquids for 4 years. Barium contrast esophagram was attempted; however, the patient aspirated a large volume of contrast medium (image A). She experienced acute hypoxic respiratory failure requiring intubation. Bronchoscopy was performed with aspiration of about 5 mL of contrast, and she was extubated without complication. Because of the high risk of aspiration events recurring, she elected for surgical gastronomy tube placement for enteral nutrition and remained in stable condition on follow-up after discharge.
Barium sulfate aspiration is a rare cause of clinically significant pulmonary disease.1-3 Risk factors for barium contrast aspiration include advanced age,1-3 known oropharyngeal dysphagia,3 head and neck cancers,3 and vomiting.2 Management includes supportive care with oxygen and chest physiotherapy.2 Bronchoscopy with suction may be used with caution in severe cases; however, there is risk of seeding of contrast throughout the bronchial tree.1,2
References
1. Gendeh HS , HashimND, YunusMR, GendehBS, KosaiNR. The sequelae of barium aspiration.ANZ J Surg.2016;88(9):937-938. doi:10.1111/ans.13624Search in Google Scholar PubMed
2. Jo H , ParkJ, MinD, et al.Incidence of pneumonia after videofluoroscopic swallowing study and associated factors.Dysphagia. 2015;31(1):41-48. doi:10.1007/s00455-015-9656-8Search in Google Scholar PubMed
3. Hamid M , UllahW, RashidMU, AmjadW, MukhtarM, HurairahA. An esophagogram or tracheobronchogram? a review of barium sulfate aspiration. J Investig Med High Impact Case Rep. 2018;6:232470961880287. doi:10.1177/2324709618802872Search in Google Scholar PubMed PubMed Central
© 2019 American Osteopathic Association
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Articles in the same Issue
- LETTERS TO THE EDITOR
- Response
- Contemporary Routes of Cannabis Consumption
- ORIGINAL CONTRIBUTION
- Using the Multitheory Model to Predict Initiation and Sustenance of Physical Activity Behavior Among Osteopathic Medical Students
- Influence of Osteopathic Medical Students’ Personal Health on Attitudes Toward Counseling Obese Pediatric Patients
- Empathy in Medicine Osteopathic and Allopathic Physician Interpersonal Manner, Empathy, and Communication Style and Clinical Status of Their Patients: A Pain Registry–Based Study
- REVIEW
- Stretch Receptor and Somatic Dysfunction: A Narrative Review
- JAOA/AACOM MEDICAL EDUCATION
- Empathy in Medicine National Norms for the Jefferson Scale of Empathy: A Nationwide Project in Osteopathic Medical Education and Empathy (POMEE)
- Novel Approach to Introducing an Ultrasonography Curriculum With Limited Instructor Resources
- CLINICAL IMAGES
- Barium Contrast Aspiration
