Korean Journal of Critical Care Medicine  2017;32(1):74-78

doi:10.4266/kjccm.2016.00409

Recurrent Aspiration Pneumonia due to Anterior Cervical Osteophyte.

Jae Jun LEE ; Ji Young HONG ; Jun Han JUNG ; Jun Hyeok YANG ; Jun Young SOHN

Keywords

hyperostosis; pneumonia; aspiration; vomiting

Country

Republic of Korea

Language

English

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.