Management of emergency care, Rare co-existance of disease or pathology
Killen H. Briones-Claudett, Mónica H. Briones-Claudett, Cesar Andrade Cabrera, Killen H. Briones Zamora, Diana C. Briones Márquez, Jaime Benítes Solís, Michelle Grunauer
Faculty of Medical Sciences, University of Guayaquil, Guayaquil, Ecuador
Am J Case Rep 2020; 21:e923776
Available online: 2020-06-30
Mendelson’s syndrome consists of pulmonary aspiration of acidic gastric contents that results in acute lung injury (chemical pneumonitis).
CASE REPORT: We present the case of a 15-year-old girl who was admitted to the Emergency Department 1 h after ingestion of an organophosphate pesticide. The patient had abundant emesis of aqueous, transparent content, accompanied by drowsiness and moderate sialorrhea. We observed drooling and foaming at the mouth and tachycardia, and her oxygen saturation dropped to 75%, requiring immediate invasive ventilation.
Computed tomography (CT) revealed opacities in both lung bases, while bronchoscopy evidenced burn lesions along the airway. A bronchoalveolar lavage (BAL) was performed and microbiological results were negative. Following the BAL, the patient showed a satisfactory evolution and full recovery.
CONCLUSIONS: This case report describes chemical pneumonitis due to pulmonary aspiration of sterile gastric contents following ingestion of a pesticide. We discuss the importance of timely diagnosis, the characteristic burn lesions found in bronchoscopy, and the role of bronchoalveolar lavage, which most likely allowed for a rapid recovery with favorable results.
Keywords: Bronchoalveolar Lavage Fluid, Bronchoscopy, Respiratory Aspiration of Gastric Contents