Pediatric Aspiration Pneumonia

Etiology: Food and or gastric contents enter the air spaces resulting in a chemical pneumonitis
— Newborns and infants who have not yet completely developed their swallow mechanism
— Children whose swallow mechanism has been damaged due to stroke or intracranial trauma
— Gastroesophageal reflux
— Gastric distension during anesthesia
— Esophageal atresia with H-type tracheoesophageal fistula
Imaging: Diffuse lung infiltrates which classically are in the right upper lobe
DDX:
Complications:
Treatment: Improve swallow mechanism, feedings delivered via feeding tube, thickening of feedings, anti-reflux measures taken after feeding
Clinical:

Radiology Cases of Aspiration Pneumonia

CXR of aspiration pneumonia — CXR AP shows a dense infiltrate in the lateral aspect of the right upper lobe.

CXR of aspiration pneumonia — CXR AP shows a dense infiltrate in the apical aspect of the right upper lobe. The stomach is air-filled and distended.

CXR of pulmonary edema in near drowning — CXR AP shows a normal sized heart and bilateral perihilar interstitial infiltrates. There is also a dense opacity in the right upper lobe.

UGI of esophageal atresia with H-type tracheo-esophageal fistula — 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.

CXR of esophageal atresia with H-type tracheo-esophageal fistula — CXR shows diffuse infiltrates in the right upper and lower lobes and hyperexpansion. An upper GI showed a fistula between the esophagus and trachea.