73-year-old man presents with respiratory difficulty following trauma and technically difficult placement of a nasogastric tube.
Air Fluid Level in the Trachea
73-year-old man presents with respiratory difficulty following trauma and technically difficult placement of a nasogastric tube. CT scan through the upper chest at the level of the aortic arch shows an air fluid level in the trachea suggesting recent aspiration.
Ashley Davidoff MD TheCommonVein.net 135762ac
Small Airway Disease
Mosaic Attenuation Micronodules and Tree in Bud
73-year-old man presents with respiratory difficulty following trauma and difficult placement of a nasogastric tube. CT scan through the upper chest at the level of the right pulmonary artery shows a focus of mosaic attenuation in the right upper lobe with a central vasoconstricted vessel (b blue arrowhead). The left upper lobe bronchus contains aspirated material (c yellow arrowhead) and there are multiple ill-defined micronodules (b, white circle). The left lower lobe shows peripheral tree in bud nodularity (d green arrowhead). In the clinical context of technical difficulty with a recently placed NG tube acute, aspiration of fluid gastric content with small airway involvement is a diagnostic consideration despite the lack of alveolar changes
Ashley Davidoff MD TheCommonVein.net 135762cL
Aspirated Fluid in the Lower Airways
73-year-old man presents with respiratory difficulty following trauma and difficult placement of a nasogastric tube. CT scan through the chest at the level of the left atrium shows aspirated material in the left lower segmental airways and inferior lingula airways. There is thickening of the right sided segmental airways as well. Extensive ill-defined micronodules are noted throughout the lung fields. Centrilobular nodules are noted in the periphery of the left lower lobe. In the clinical context of technical difficulty with a recently placed NG tube acute, aspiration of fluid gastric content with small airway involvement is a diagnostic consideration despite the lack of alveolar changes
Ashley Davidoff MD TheCommonVein.net 135763c
73-year-old man presents with respiratory difficulty following trauma and difficult placement of a nasogastric tube. CT scan through the chest at the level of the left atrium shows aspirated material in the left lower segmental airways. There is thickening of the right sided segmental airways as well. Extensive ill-defined micronodules are noted throughout the lung fields. Centrilobular nodules are noted in the periphery of the left lower lobe. In the clinical context of technical difficulty with a recently placed NG tube acute, aspiration of fluid gastric content with small airway involvement is a diagnostic consideration despite the lack of alveolar changes
Ashley Davidoff MD TheCommonVein.net 135765
73-year-old man presents with respiratory difficulty following trauma and difficult placement of a nasogastric tube. Sagittal CT reconstruction through the left chest at the level of the left ventricle shows aspirated material in the left lower segmental airways. Extensive ill-defined micronodules are noted throughout the left lower lobe. Centrilobular nodules are noted in the periphery of the left lower lobe. In the clinical context of technical difficulty with a recently placed NG tube acute, aspiration of fluid gastric content with small airway involvement is a diagnostic consideration despite the lack of alveolar changes
Ashley Davidoff MD TheCommonVein.net 135766c
73-year-old man presents with respiratory difficulty following trauma and difficult placement of a nasogastric tube. Coronal CT reconstruction through the posterior chest at the level of the esophagus shows aspirated material in the bilateral basilar segmental airways (yellow arrowheads). Extensive ill-defined micronodules are noted throughout the left lower lobe. In the clinical context of technical difficulty with a recently placed NG tube acute, aspiration of fluid gastric content with small airway involvement is a diagnostic consideration despite the lack of alveolar changes
Ashley Davidoff MD TheCommonVein.net 135767c