Silent pulmonary aspiration of barium after esophagogastroduodenography and subtotal gastrectomy

We describe a 66-year-old patient who underwent subtotal gastrectomy and omentectomy for gastric adenocarcinoma six days after esophago-gastro-duodenography with barium contrast medium. In the postoperative period a series of chest films showed bronchogram due to aspiration of the contrast medium from the stomach, and finally multiple cottony infiltrates bilaterally. The patient had no respiratory symptoms and 6 days after admission to the intensive care recovery unit, he was moved to the general surgery ward for observation. Follow-up later passed to the outpatient with satisfactory evolution. We conclude that pulmonary aspiration occurred after extubation in the operating theater, since during the operation the patient remained stable hemodynamically and respiratorily. This case corroborates the theory of the existence of silent aspiration without pulmonary complications and the need to adjust clinical treatment, which can be conservative when, once the process is diagnosed, no symptoms present.