Acute aspiration pneumonitis
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- updated 25 Sep 2023:
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Acute aspiration pneumonitis occurs occurs when solid or liquid ingested particles enter the airways and lungs, leading to inflammation.
This article will focus on the acute form of aspiration (cf. chronic aspiration pneumonia), mainly concerning its radiographic features; for a broader discussion, please refer to the parent article on aspiration pneumonia.
Radiographic features
Features can be variable and range from a pulmonary oedema pattern to areas of consolidation. CT is superior to plain films in demonstrating mild aspiration and distal airway involvement. Findings on imaging typically include 3:
-
centrilobular nodules, often in a tree-in-bud pattern
reflect distal airways impaction of the aspirated particles
-
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
These changes may have a gravity-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/bronchiolectasis, and/or presence of a reticular interstitial pattern.
See also
-<p><strong>Acute aspiration pneumonitis</strong> occurs when solid or liquid ingested particles enter the airways and lungs, leading to inflammation. </p><p>This article will focus on the acute form of aspiration (cf. <a href="/articles/chronic-aspiration-pneumonia">chronic aspiration pneumonia</a>), mainly concerning its radiographic features; for a broader discussion, please refer to the parent article on <a href="/articles/aspiration-pneumonia">aspiration pneumonia</a>.</p><h4>Radiographic features</h4><p>Features can be variable and range from a pulmonary oedema pattern to areas of consolidation. CT is superior to plain films in demonstrating mild aspiration and distal airway involvement. Findings on imaging typically include <sup>3</sup>: </p><ul>-<li>-<p>centrilobular nodules, often in a <a href="/articles/tree-in-bud-sign-lung">tree-in-bud pattern</a> </p>-<ul><li><p>reflect distal airways impaction of the aspirated particles </p></li></ul>-</li>-<li>-<p><a href="/articles/ground-glass-opacification-3">ground-glass opacities</a></p>-<ul><li><p>reflect the associated parenchymal inflammation </p></li></ul>-</li>-<li><p>central airways plugging may be seen </p></li>-<li>-<p><a href="/articles/segmental-atelectasis">segmental</a> or <a href="/articles/lobar-lung-collapse">lobar atelectasis</a> </p>-<ul><li><p>enhancing lung parenchyma and volume loss </p></li></ul>-</li>-<li>-<p>consolidation </p>-<ul>-<li><p>may be mixed with areas of atelectasis, but instead shows no enhancement</p></li>-<li><p>"<a href="/articles/aspiration-pneumonia">aspiration pneumonia</a>" </p></li>-</ul>-</li>-</ul><p>These changes may have a gravity-dependent distribution:</p><ul>-<li><p>posterior segment of the upper lobes and the superior segment of the lower lobes - commonly seen when aspiration occurs in a recumbent patient</p></li>-<li><p>bilateral basal segments, middle lobe and lingula - commonly seen in erect patients</p></li>-</ul><p>In contrast to a <a href="/articles/chronic-aspiration-pneumonia">chronic</a> aetiology, there is no or little evidence of prominent <a href="/articles/septal-lines-in-lung-1">septal lines</a>, regions of <a href="/articles/bronchiectasis">bronchiectasis</a>/<a href="/articles/bronchiolectasis-1">bronchiolectasis</a>, and/or presence of a <a href="/articles/reticular-interstitial-pattern">reticular interstitial pattern</a>.</p><h4>See also</h4><ul>-<li><p><a href="/articles/pulmonary-aspiration-diseases">pulmonary aspiration syndromes</a></p></li>-<li><p><a href="/articles/aspiration-bronchiolitis">aspiration bronchiolitis</a></p></li>-<li><p><a href="/articles/mendelson-syndrome" title="Mendelson syndrome">Mendelson syndrome</a></p></li>- +<p><strong>Acute aspiration pneumonitis</strong> occurs when solid or liquid ingested particles enter the airways and lungs, leading to inflammation. </p><p>This article will focus on the acute form of aspiration (cf. <a href="/articles/chronic-aspiration-pneumonia">chronic aspiration pneumonia</a>), mainly concerning its radiographic features; for a broader discussion, please refer to the parent article on <a href="/articles/aspiration-pneumonia">aspiration pneumonia</a>.</p><h4>Radiographic features</h4><p>Features can be variable and range from a pulmonary oedema pattern to areas of consolidation. CT is superior to plain films in demonstrating mild aspiration and distal airway involvement. Findings on imaging typically include <sup>3</sup>: </p><ul>
- +<li>
- +<p>centrilobular nodules, often in a <a href="/articles/tree-in-bud-sign-lung">tree-in-bud pattern</a> </p>
- +<ul><li><p>reflect distal airways impaction of the aspirated particles </p></li></ul>
- +</li>
- +<li>
- +<p><a href="/articles/ground-glass-opacification-3">ground-glass opacities</a></p>
- +<ul><li><p>reflect the associated parenchymal inflammation </p></li></ul>
- +</li>
- +<li><p>central airways plugging may be seen </p></li>
- +<li>
- +<p><a href="/articles/segmental-atelectasis">segmental</a> or <a href="/articles/lobar-lung-collapse">lobar atelectasis</a> </p>
- +<ul><li><p>enhancing lung parenchyma and volume loss </p></li></ul>
- +</li>
- +<li>
- +<p>consolidation </p>
- +<ul>
- +<li><p>may be mixed with areas of atelectasis, but instead shows no enhancement</p></li>
- +<li><p>"<a href="/articles/aspiration-pneumonia">aspiration pneumonia</a>" </p></li>
- +</ul>
- +</li>
- +</ul><p>These changes may have a gravity-dependent distribution:</p><ul>
- +<li><p>posterior segment of the upper lobes and the superior segment of the lower lobes - commonly seen when aspiration occurs in a recumbent patient</p></li>
- +<li><p>bilateral basal segments, middle lobe and lingula - commonly seen in erect patients</p></li>
- +</ul><p>In contrast to a <a href="/articles/chronic-aspiration-pneumonia">chronic</a> aetiology, there is no or little evidence of prominent <a href="/articles/septal-lines-in-lung-1">septal lines</a>, regions of <a href="/articles/bronchiectasis">bronchiectasis</a>/<a href="/articles/bronchiolectasis-1">bronchiolectasis</a>, and/or presence of a <a href="/articles/reticular-interstitial-pattern">reticular interstitial pattern</a>.</p><h4>See also</h4><ul>
- +<li><p><a href="/articles/pulmonary-aspiration-diseases">pulmonary aspiration syndromes</a></p></li>
- +<li><p><a href="/articles/aspiration-bronchiolitis">aspiration bronchiolitis</a></p></li>
- +<li><p><a href="/articles/mendelson-syndrome" title="Mendelson syndrome">Mendelson syndrome</a></p></li>
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Case 34: Mendelson syndrome
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