[Dysphagia] Aspiration etc.

[eripley at yahoo.com (Irene Campbell-Taylor)]

The following might answer a few questions: 
  The many faces of pulmonary aspiration.  ?         Marom EM, 
  ?         McAdams HP, 
  ?         Erasmus JJ, 
  ?         Goodman PC. 
  Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
  The clinical and radiologic manifestations of aspiration are truly protean. The diagnosis is straightforward in patients with known risk factors and new radiographic findings in dependent portions of lung. However, diagnosis is difficult in patients without known risk factors or who present with less specific radiologic findings. Careful history-taking skills and knowledge of the diverse radiologic appearances of aspiration are thus required to facilitate diagnosis and expedite treatment.
  Radiographics. 2000 May-Jun;20(3):673-85. 
  
  And 
  Significance of chronic cough as a defence mechanism or a symptom in elderly patients with aspiration and aspiration pneumonia Eur Respir J 2005; 25:210-211  S. Teramoto, T. Ishii, H. Yamamoto, Y. Yamaguchi, R. Namba, Y. Hanaoka, M. Takizawa, T. Okada, M. Ishii and Y. Ouchi  Full text at:  http://erj.ersjournals.com/cgi/content/full/25/1/210   Aspiration diseases: findings, pitfalls, and differential diagnosis.  ?         Franquet T, 
  ?         Gimenez A, 
  ?         Roson N, 
  ?         Torrubia S, 
  ?         Sabate JM, 
  ?         Perez C. 
  Department of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona, Avda San Antonio Maria Claret 168, Barcelona 08125, Spain. 19429tfc at comb.es
  The aspiration of different substances into the airways and lungs may cause a variety of pulmonary complications. These disease entities most commonly involve the posterior segment of the upper lobes and the superior segment of the lower lobes. Esophagography and computed tomography (CT) are especially useful in the evaluation of aspiration disease related to tracheoesophageal or tracheopulmonary fistula. Foreign body aspiration typically occurs in children and manifests as obstructive lobar or segmental overinflation or atelectasis. An extensive, patchy bronchopneumonic pattern may be observed in patients following massive aspiration of gastric acid or water. CT is the modality of choice in establishing the diagnosis of exogenous lipoid pneumonia, which can result from aspiration of hydrocarbons or of mineral oil or a related substance. Aspiration of infectious material manifests as necrotizing consolidation and abscess formation. The relatively low diagnostic accuracy
 of chest radiography in aspiration diseases can be improved with CT and by being familiar with the clinical settings in which specific complications are likely to occur. Recognition of the varied clinical and radiologic manifestations of these disease entities is imperative for prompt, accurate diagnosis, resulting in decreased morbidity and mortality rates.
  Complete articles at:
  http://radiographics.rsnajnls.org/cgi/content/full/20/3/673
  and see
. chronic occult aspiration in the elderly at:
  http://www.chestjournal.org/cgi/reprint/110/5/1289?ijkey=db07952ab9355e6c9d3e418b6a99b63a58c5c65f
   


Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com