Pediatric Aerophagia

  • Etiology:
    — Esophageal intubation
    — Continuous positive airway pressure (CPAP)
    — Excessive crying
    — Excessive air swallowing in patients with psychiatric or neurological disorders
  • Imaging AXR: Diffuse dilation of stomach and small bowel and colon without signs of obstruction
  • DDX: Ileus
  • Complications:
  • Treatment: Decrease amount of air swallowing
  • Clinical: Presents with persistent severe abdominal distension

Radiology Cases of Aerophagia

Radiology Cases of Aerophagia Due to Continuous Positive Airway Pressure

AXR of aerophagia due to CPAP
AXR AP shows multiple dilated loops of bowel throughout the abdomen. The nasogastric tube tip projects over the body of the stomach.

Radiology Cases of Aerophagia Due to Esophageal Intubation

CXR of esophageal intubation
CXR AP (above) shows nasogastric tube with its tip within a distended stomach. An endotracheal tube is present to the right of the nasogastric tube and is projecting over an air-distended esophagus. There is near-complete atelectasis of the right lung. CXR AP (below) after reintubation now shows the endotracheal tube to the left of the nasogastric tube and interval resolution of the esophageal and gastric distension.
CXR of endotracheal tube in the esophagus
CXR AP shows an endotracheal tube with its tip projecting over the left side of the spine with its tip beneath the carina. There is complete atelectasis of the left lung with mediastinal shift to the left. The stomach is massively distended with air.