Am. J. Respir. Crit. Care Med., Volume 156, Number 1, July 1997, 292-295

Sand Aspiration with Near-drowning
Radiographic and Bronchoscopic Findings

DONNIE P. DUNAGAN, JOSEPH E. COX, MICHAEL C. CHANG, and EDWARD F. HAPONIK

Departments of Medicine, Radiology, and Surgery, Bowman Gray School of Medicine, Wake Forest University Medical Center, Winston-Salem, North Carolina

Sand and foreign-body aspiration may accompany drowning and near-drowning, but few details regarding such patients are available in the literature. We report a 26-yr-old woman who suffered near-drowning after a motor-vehicle accident. Initial attempts at ventilation were compromised by increased peak airway pressures, which decreased following the removal of large amounts of sand from the patient's endotracheal tube. Chest radiographs and computed tomographic (CT) scans of the patient obtained upon her arrival in the emergency department demonstrated sand bronchograms within the lower lobes of both lungs, and sand within the maxillary sinuses and stomach. We present the radiographic, bronchoscopic, and microbiologic findings within hours after this patient's accident, with a review of the literature and provisional recommendations for the management of such patients.

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