CT characteristics of bronchopulmonary abnormalities caused by pepper aspiration

Abstract

Abstract Purpose: To investigate the computed tomography (CT) characteristics of bronchopulmonary abnormalities caused by pepper aspiration for improving diagnosis. Materials and methods: From January 2016 to September 2022, 28 adult patients with confirmed obstructive pneumonia caused by pepper aspiration were enrolled. The CT characteristics of bronchial changes and pulmonary lesions caused by pepper were analyzed and summarized. Results: Among the 28 patients, the most common symptom was cough (26, 92.9%), followed by expectoration (23, 82.1%). Bronchoscopy examination revealed that the pepper was mainly located in the right lower lobe bronchus (18, 64.3%), followed by the left lower lobe bronchus (5, 17.9%). In combination with bronchoscopy results, the pepper in bronchus was manifested as circular or V/U-shaped high density, localized soft tissue, and flocculent opacification in 8 (28.6%), 16 (57.1%), and 3 (10.7%) cases on CT images, respectively. The bronchial wall around the pepper was thickened with localized occlusion (19, 67.9%) and stenosis (9, 32.1%). Regarding the adjacent bronchi without pepper, extensive wall thickening with stenosis and/or occlusion were found in 23 (82.1%) cases. Distal pulmonary lesions frequently involved two or three segments (21, 75.0%) and mainly presented as patchy consolidation or atelectasis (24, 85.7%). Conclusion: In combination to history of eating pepper and clinical symptoms, bronchopulmonary abnormalities caused by pepper should be highly suspected if U/V shaped and annular high density or localized soft tissue density was detected in the lower lobe bronchus, with extensive bronchial wall thickening, stenosis, or occlusion, and consolidation or atelectasis in multiple distal lung segments.