Barium sulfate aspiration: Is early bronchioalveolar lavage a life-saving procedure?
Amarjeet Kumar1
, Ajeet Kumar2, Neeraj Kumar1, Chandni Sinha2, Jitendra Kumar Singh2
1Departments of Trauma and Emergency, All India Institute of Medical Sciences, Patna, Bihar, India
2Department of Anaesthesia, All India Institute of Medical Sciences, Patna, Bihar, India
Abstract
Aspiration of barium sulfate is a well-known complication, occurring accidentally during contrast-enhanced examinations of the upper gastrointestinal system. Massive aspiration of contrast material causes mechanical obstruction that increases alveolar dead space leading to altered ventilation/perfusion (V/Q) ratio with secondary respiratory failure and death. The potential treatment strategies include early recognition of predisposing factors, pretreatment with antireflux medications, such as domperidone, correct choice of contrast media, and use of retroesophageal suction catheter during barium swallow study. We report a case of barium swallow aspiration, which was successfully managed by early institution of bronchioalveolar lavage (BAL) and positive pressure mechanical ventilation. Till date, BAL has not been recommended for the same, with studies showing it can worsen the clinical scenario.
How to cite this article: Kumar A, Kumar A, Kumar N, Sinha C, Singh JK. Barium sulfate aspiration: Is early bronchioalveolar lavage a life-saving procedure?. Turk J Emerg Med 2020;20:50-3
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AK and JKS managed the patient. AK and JKS followed the patient. CS reviewed the literatures. CS and NK wrote the draft. All authors revised and approved the final version of the manuscript.
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We would like to thank Dr Bhartendu bharti, Assistant Professor, Department of ENT, AIIMS, Patna for providing constant support in writing of the study.