Szintigraphischer Nachweis einer stillen Aspiration nach beidseitiger Lungentransplantation

Zusammenfassung

Vorgestellt wird der Fall einer 25jährigen Patientin nach beidseitiger Lungentransplantation und rezidivierenden Pneumonien. Klinisch bestand der Verdacht auf eine stille Aspiration. Szintigraphisch gelang sowohl der Aspirationsnachweis als auch eine Differenzierung hinsichtlich der Genese: direkte oro-pulmonale Aspiration versus Aspiration nach gastro-öspohagealem Reflux.

Summary

We present a case of a 25 year old patient who underwent double-sided lung transplantation and suffered from recurrent pneumonia. Silent aspiration was suspected clinically. Aspiration was proved by scintigraphy enabling to discriminate between direct oro-pulmonal aspiration and aspiration after gastro-esophageal reflux.

Schlüsselwörter

Aspirationsszintigraphie - stille Aspiration - Lungentransplantation

Key words

Aspiration scintigraphy - silent aspiration - lung transplantation

• Literatur

• 1 Heyman S, Respondek M. An improved methode for the diagnosis gastroesophageal reflux and aspiration in children (milk scan). Radiology 1979; 131: 479-82.
• 2 Kikuchi R, Watabe N, Konno T, Mishina N, Sekizawa K, Sasaki H. High incidence of silent aspiration in elderly patients with community-acquired pneumonia. Am J Respir Crit Care Med 1994; 150 (Suppl. 01) 251-3.
• 3 Kirk AJB, Colquhoun IW, Corris PA, Hilton CJ, Dark JH. Impaired gastrointestinal motility in pulmonary transplantation. The Lancet 1990; 336: 752.
• 4 Köhler D, Vastag E. Bronchiale Clearance. Pneumologie 1991; 45: 313-32.
• 5 Muz J, Mathog RH, Rosen R, Miller PR, Borrero G. Detection and quantification of laryngotracheopulmonary aspiration with scintigraphy. Laryngoscope 1987; 96: 1180-5.
• 6 Ott DJ, Peele VN, Chen YM, Gelfand DW. Oropharyngeal function of evaluating swallowing difficulty. South Med J 1990; 1: 152-6.
• 7 Reid KR, McKenzie FN, Menkis AH, No-vick RJ, Pflugfelder PW, Kostuk WJ, Ahmad D. Importance of chronic aspiration in recipients of heart-lung transplants. The Lancet 1990; 336: 206-8.
• 8 Ruth M, Carlsson S, Mansson I, Bengtsson U, Sandberg N. Scintigraphic detection of ga-stro-pulmonary aspiration in patients with respiratory disorders. Clin Physiol 1993; 13 (Suppl. 01) 19-33.
• 9 Silver KH, Van Nostrand D, Kuhlemeier KV, Siebens AA. Arch Phys Med. Rehabil 1991; 72 (Suppl. 11) 902-10.
• 10 Silver KH, Van Nostrand D. The use of scintigraphy in the managment of patients with pulmonary aspiration. Dysphagia 1994; 9 (Suppl. 02) 107-15.