Prognosis
Aspiration of gastric contents results in limited disease in most patients. Aspiration can be asymptomatic. However, it can result in chemical pneumonitis and acute respiratory distress syndrome (ARDS);[2] mortality is high if patients progress to ARDS. ARDS usually develops within 2 to 5 hours of aspiration. The clinical course is variable: in one small retrospective study, 12% of patients had a fulminant course and died shortly after aspiration of gastric contents; in 62% the chest x-ray improved rapidly within 5 days after aspiration; however, in 26% this initial improvement was followed by the development of new infiltrates on chest x-ray, probably indicating complicating bacterial pneumonia, and of this group over 60% died as a consequence.[42] The aspiration injury usually begins to resolve within 72 hours. Death as a result of aspiration of gastric contents as a consequence of anaesthesia is rare, with rates varying from 0% to 5%.[3]
Because of the inert character of barium, long-term reactions and late toxicities are rare, and complete radiological clearance is expected. There are no extensive data on long-term complications from massive barium aspiration, but case reports suggest that abnormalities can be seen on high-resolution computed tomography scan up to 1 year later.[74] Therefore, it is reasonable to obtain follow-up chest imaging during the year after barium aspiration.
Use of this content is subject to our disclaimer