Tracheobronchial aspiration observed during ventilation perfusion lung scanning

A 49-year-old man with a history of athetoid cerebral palsy, cervical spondylosis, and swallowing dysfunction underwent an anterior decompressive cordectomy and spinal fusion of C4 through C6. Approximately 1 month following surgery, the patient experienced acute shortness of breath and ventilation-perfusion lung imaging was performed to rule out pulmonary embolus. The Tc-99m DTPA aerosol ventilation scan demonstrated tracheobronchial aspiration and correlated well with the patient's subsequent development of aspiration pneumonia and the adult respiratory distress syndrome.