Gastroenterology: Bronchoaspiration: Neurological Child

Abstract

Recurrent pneumonia secondary to bronchial aspiration is typical of neurologically impaired children; both radionuclide salivagram and gastroesophageal reflux scintigraphy are commonly used in the detection of pulmonary aspiration. Radionuclide salivagram visualizes activity in trachea and bronchi secondary to salivary aspiration, while gastroesophageal scintigraphy detects labeled meal in respiratory airway. Furthermore, aspiration can occur by two routes (anterograde and retrograde), and each nuclear medicine imaging targeting different types of pulmonary aspiration should be required according to specific clinical suspicion. Sometimes, it could be helpful to perform both examinations, beginning by gastric emptying and performing salivagram in case of no evidence of aspiration during gastric emptying test. It is crucial to perform gastroesophageal scintigraphy administering an appropriate amount of labeled meal to reduce the risk of false-negative tests due to poor filling of the stomach.