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Barium Aspiration in 76 y/o male patient ..During evaluation of dysphagia

The film showed barium in both the right and left main stem bronchi, outlining the bronchus intermedius, all four lower-lobe basal bronchi, and the segmental bronchi in the left upper and lower lobes. The barium also spread into the smaller airways, producing a tree-in-bud appearance (arrow).

The patient underwent bronchoscopy, which confirmed the presence of barium in the right and left lower lobes and lingula. The barium was suctioned extensively.

Circulatory shock developed, and the patient had severe anoxic brain injury after cardiac arrest,then

he died shortly thereafter.

n engl j med 366;11

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