Mendelsons syndrome complicated by acute respiratory distress syndrome

Abstract

The article presents a clinical case of aspiration pneumonia (Mendelson's syndrome) complicated by acute respiratory syndrome. Clinical symptomatology of patient S., 39 years old, hospitalized at the University Clinic of Ivano-Frankivsk on November 5, 2012, included predominantly shortness of breath and cough, and hemoptysis was observed. Extensive (almost total) radiological changes in both pulmonary fields dissonated with relatively poor auscultatory data, namely, only weakened vesicular respiration was heard throughout the clinical observation period. The data of X-ray examination somewhat resembled the disseminated process, and therefore in some cases were interpreted as a case of the firstly diagnosed pulmonary tuberculosis (FDPTB), and later as viral and bacterial pneumonia due to the epidemiological situation regarding the outbreak of California influenza in 2009-2011. However, with scrupulous survey, we managed to find out that a prerequisite for breathlessness and coughing was repeated vomiting in patient in the evening and night because of frequent epileptic attacks. This fact contributed to the formation of a proper clinical diagnosis of aspiration pneumonia complicated by acute respiratory distress syndrome. The peculiarity of this clinical observation was the fact that it occured on the comorbidities background (epilepsy; chronic internal hemorrhoids, complicated with rectal bleeding on October 3, 2012 and posthemorrhagical anemia; acute deep vein thrombosis and acute ascending thrombophlebitis of the varicose dilated saphenous veins of both lower limbs). However, with adequate mask mechanical ventilation, antibiotic therapy, mucolytics, clexane, cardiomagnyl, normoven, elastic compression of the lower extremities, dosed exercises, a rapid clinical and particularly radiological dynamic on November 9, 2012 was noted. Due to this on December 13, 2012 the patient was discharged in satisfactory condition for outpatient treatment.