Korean J Crit Care Med.  2017 Feb;32(1):74-78. 10.4266/kjccm.2016.00409.

Recurrent Aspiration Pneumonia due to Anterior Cervical Osteophyte

• Lee JJ
• Hong JY
• Jung JH
• Yang JH
• Sohn JY

• KMID: 2371157
• DOI: http://doi.org/10.4266/kjccm.2016.00409

Abstract

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.

Keyword

hyperostosis; pneumonia; aspiration; vomiting

MeSH Terms

Aged
Bays
Decompression, Surgical
Deglutition
Esophagus
Gastrostomy
Humans
Hyperostosis
Hypoxia, Brain
Intensive Care Units
Neck Pain
Osteophyte*
Pneumonia
Pneumonia, Aspiration*
Shock, Septic
Spine
Vomiting

Figure

• 

  Figure 1. VFSS shows diffuse idiopathic skeletal hyperostosis of the cervical spine and anterior diversion of a bolus of barium into the laryngeal inlet (white arrow), secondary to osteophytes. VFSS: videofluoroscopic swallowing study.

• 

  Figure 2. Cervical computed tomography shows anterior osteophytes at the C3-6 and T1-2 levels.

Reference

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