Presentation
Long recovery after anesthesia for brain MRI, coughing and low blood gases.
Patient Data
There are diffuse alveolar infiltrates within the left cranial lung lobe with air bronchograms. An endotracheal tube is present within the trachea and terminates at the area of the thoracic inlet. The intrathoracic esophagus is severely gas distended. There is incidental mineral foreign material in the stomach. The pulmonary pattern is consistent with aspiration pneumonia post anesthesia.
Case Discussion
Aspiration pneumonia can occur under anesthesia as the esophagus is lax allowing reflux, and gastric fluids bypass the larynx and endotracheal tube cuff. This case was severe enough to require mechanical ventilation.
The air bronchograms are visible when the left lateral lung lobe is compressed and nearest to the table. The alveolar pattern is also visible on the right lateral projection when the left cranial lung lobe is not compressed and better inflated.
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