CTICasesAspiration Pneumonitis due to Esophageal Dysmotility (Corkscrew Esophagus)
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Imaging findings
Chest radiograph showed a pigtail catheter post-pleural effusion drainage. A striking column of barium was present in the lungs, indicating aspiration. A prior swallow study revealed severe esophageal dysmotility, characterized by a 'corkscrew esophagus,' and an intrathoracic component of the stomach. The pleural collection was suspected to be a result of aspiration.
Key takeaways
Severe esophageal dysmotility, such as corkscrew esophagus, can lead to recurrent aspiration events, resulting in pulmonary complications like aspiration pneumonitis and pleural effusions. The presence of barium in the lungs on a chest radiograph post-swallow study is a direct sign of aspiration. Hiatal hernia with an intrathoracic stomach component can further predispose to aspiration.
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