Pediatric Aspiration

Etiology:
— Lack of oropharyngeal coordination
— Massive gastroesophageal reflux
Imaging Fluoroscopy: Contrast material within the trachea
DDX:
Complications: Aspiration pneumonia
Treatment: Improve swallow mechanism, feedings delivered via feeding tube, thickening of feedings, anti-reflux measures taken after feeding
Clinical:

Radiology Cases of Aspiration

Upper GI of tracheal aspiration — Lateral image from an upper GI shows barium in the trachea anteriorly as well as in the pharynx and esophagus posteriorly.

Upper GI of aspiration due to gastroesophageal reflux — Upper GI exam shows a markedly distended stomach with marked gastroesophageal reflux rising to the level of the oropharynx and entering into the trachea clearly outlining the trachea to the right of the esophagus on the AP image (left) and anterior to the esophagus on the lateral image (right).

Texture swallow study showing aspiration of barium — CXR AP obtained after the texture swallow exam shows barium coating the lower trachea and the left and right mainstem bronchi.