Acute aspiration pneumonitis

Changed by Bruno Di Muzio, 12 Sep 2020

Updates to Article Attributes

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Acute aspiration pneumonitis refers occurs when solid or liquid ingested particles get into the airways and lungs leading to inflammation. 

This article will focus on the acute form of aspiration (c.f. chronic aspiration pneumonia), mainly in regards to its radiographic features, for a formbroader discussion, please, refer to the parental article on aspiration pneumonia where the time of onset is rapid.

Radiographic features

Plain radiograph / CT

Features can be variable and can range from a pulmonary oedema pattern to areas of consolidation. CT is superior to plain films in demonstrating mild aspiration and the distal airways involvement. Findings on imaging typically include 3

  • centrilobular nodules, often in a tree-in-bud pattern 
    • reflect distal airways impaction of the aspirated particles 
  • ground-glass opacities
    • reflect the associated parenchymal inflammation 
  • central airways plugging may be seen  
  • segmental or lobar atelectasis 
    • enhancing lung parenchyma and volume loss 
  • consolidation 
    • may be mixed with areas of atelectasis, but instead shows no enhancement
    • "aspiration pneumonia" 

These changes may have a gravity dependent-dependent distribution. :

  • posterior segment of the upper lobes and the superior segment of the lower lobes - commonly seen when aspiration occurs in a recumbent patient
  • bilateral basal segments, middle lobe, and lingula - commonly seen in erect patients

In contrast to a chronic aetiology, there is no or little evidence of prominent septal lines, regions of bronchiectasis/bronchioloectasis, and/or presence of a reticular interstitial pattern.

See also

  • -<p><strong>Acute aspiration pneumonitis</strong> refers to a form <a href="/articles/aspiration-pneumonia">aspiration pneumonia</a> where the time of onset is rapid.</p><h4>Radiographic features</h4><h5>Plain radiograph / CT</h5><p>Features can be variable and can range from a pulmonary oedema pattern to areas of consolidation. These changes may have a gravity dependent distribution. In contrast to a <a href="/articles/chronic-aspiration-pneumonia">chronic</a> aetiology, there is no or little evidence of prominent septal lines, regions of bronchiectasis/bronchioloectasis and/or presence of a reticular interstitial pattern.</p><h4>See also</h4><ul>
  • +<p><strong>Acute aspiration pneumonitis</strong> occurs when solid or liquid ingested particles get into the airways and lungs leading to inflammation. </p><p>This article will focus on the acute form of aspiration (c.f. <a href="/articles/chronic-aspiration-pneumonia">chronic aspiration pneumonia</a>), mainly in regards to its radiographic features, for a broader discussion, please, refer to the parental article on <a href="/articles/aspiration-pneumonia">aspiration pneumonia</a>.</p><h4>Radiographic features</h4><p>Features can be variable and can range from a pulmonary oedema pattern to areas of consolidation. CT is superior to plain films in demonstrating mild aspiration and the distal airways involvement. Findings on imaging typically include <sup>3</sup>: </p><ul>
  • +<li>centrilobular nodules, often in a tree-in-bud pattern <ul><li>reflect distal airways impaction of the aspirated particles </li></ul>
  • +</li>
  • +<li>ground-glass opacities<ul><li>reflect the associated parenchymal inflammation </li></ul>
  • +</li>
  • +<li>central airways plugging may be seen  </li>
  • +<li>segmental or lobar atelectasis <ul><li>enhancing lung parenchyma and volume loss </li></ul>
  • +</li>
  • +<li>consolidation <ul>
  • +<li>may be mixed with areas of atelectasis, but instead shows no enhancement</li>
  • +<li>"aspiration pneumonia" </li>
  • +</ul>
  • +</li>
  • +</ul><p>These changes may have a gravity-dependent distribution:</p><ul>
  • +<li>posterior segment of the upper lobes and the superior segment of the lower lobes - commonly seen when aspiration occurs in a recumbent patient</li>
  • +<li>bilateral basal segments, middle lobe, and lingula - commonly seen in erect patients</li>
  • +</ul><p>In contrast to a <a href="/articles/chronic-aspiration-pneumonia">chronic</a> aetiology, there is no or little evidence of prominent septal lines, regions of bronchiectasis/bronchioloectasis, and/or presence of a reticular interstitial pattern.</p><h4>See also</h4><ul>

References changed:

  • 3. Muhammad Naeem, David H. Ballard, Hamza Jawad, Constantine Raptis, Sanjeev Bhalla. Noninfectious Granulomatous Diseases of the Chest. (2020) RadioGraphics. 40 (4): 1003-1019. <a href="https://doi.org/10.1148/rg.2020190180">doi:10.1148/rg.2020190180</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/32501738">Pubmed</a> <span class="ref_v4"></span>

Tags changed:

  • rg_40_4_edit

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