Clinical Images  |   August 2019
Barium Contrast Aspiration
Author Notes
  • From the Department of Internal Medicine at the John H. Stroger, Jr. Hospital of Cook County in Chicago, Illinois. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Parth Desai, DO, John H. Stroger, Jr. Hospital of Cook County, 1969 W Ogden Ave, Chicago IL, 60612-3765Email:
Article Information
Imaging / Pulmonary Disorders / Clinical Images
Clinical Images   |   August 2019
Barium Contrast Aspiration
The Journal of the American Osteopathic Association, August 2019, Vol. 119, 541. doi:
The Journal of the American Osteopathic Association, August 2019, Vol. 119, 541. doi:
An 82-year-old woman with type 2 diabetes mellitus was evaluated for aspiration pneumonia. She reported progressive dysphagia to solids and liquids for 4 years. Barium contrast esophagram was attempted; however, the patient aspirated a large volume of contrast medium (image A). She experienced acute hypoxic respiratory failure requiring intubation. Bronchoscopy was performed with aspiration of about 5 mL of contrast, and she was extubated without complication. Because of the high risk of aspiration events recurring, she elected for surgical gastronomy tube placement for enteral nutrition and remained in stable condition on follow-up after discharge. 
Barium sulfate aspiration is a rare cause of clinically significant pulmonary disease.1-3 Risk factors for barium contrast aspiration include advanced age,1-3 known oropharyngeal dysphagia,3 head and neck cancers,3 and vomiting.2 Management includes supportive care with oxygen and chest physiotherapy.2 Bronchoscopy with suction may be used with caution in severe cases; however, there is risk of seeding of contrast throughout the bronchial tree.1,2 

Subscribe to view more

For full access to this article, log in to an existing user account, purchase an annual subscription, or purchase a short-term subscription.

Order a subscription


Pay Per View

Entire Journal
30-Day Access


Buy Now

This Issue
7-Day Access


Buy Now

This article
24-Hour Access


Buy Now

Sign In Or Create an account

Please sign in using your login.
If you do not have an AOA login, you may create a new account.

Or Subscribe