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