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April 22, 1961

Aspiration Pneumonitis—Mendelson's Syndrome

JAMA. 1961;176(3):229-231. doi:10.1001/jama.1961.63040160013013b

MENDELSON'S syndrome, or peptic-aspiration pneumonia, was first described in obstetrical cases by Mendelson1 in 1946. Classically, there is a history of vomiting after inhalation anesthesia, either during the operation or in the early postoperative period. Two to five hours after aspiration there is a dramatic onset of cyanosis, dyspnea, tachycardia, and shock.2 Examination of the patient shows no localized signs of lung disease but generalized adventitious sounds and bronchospasm. The condition simulates pulmonary edema with rales, wheezes, and rhonchi throughout both lungs. There is a bloody, frothy sputum and marked pulmonary congestion. A very high pulse and respiratory rate are common, and gross pulmonary edema may supervene, with a rapidly deteriorating course resulting in death from cardiac failure. X-ray of the chest shows soft patchy mottling scattered through the lung fields but no evidence of lung collapse. Postmortem examination of the lungs will show gross swelling of

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