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Background; Barium aspiration is one of rare major complication of esophagography. 40% cases of aspiration pneumonia occur without clinical symptoms and the other 30% results in deaths. Case. A 62-years-old female choked some barium liquid when performing esophagography procedure. We found ronchi on lower left haemithorax and granuler hiperdensity pattern on left paracardial from chest x-ray photo. Eight days later, patient suffered the clinical symptoms of infection and from chest x-ray photo we found infiltrate and rest of barium. We found Burcholderia Gladioli and Pseudomonas containing 1,22 mg/L of barium from microbiology examination of bronchus lavage. Discussion. Barium aspiration was one of major complication in esophagography procedure in extreme age. Chest x-ray and Computed Tomography can help to diagnose and evaluate in this case. Quantity and density of barium liquid could affect the prognosis of this case. Oropharingeal which containing a number of pathogen can cause pneumonia as disease complication. There was still no guideline for barium aspiration management, but bronchoscopy was recommended by many studies. Conclusion. Pneumonia was one of barium aspiration complication. Bronchoscopy was recommended procedure as diagnose dan therapy tool for barium aspiration case. Anaerob activity antibiotic should be given when pneumonia was suspected.
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