Postgastrectomy aspiration pneumonia.

One hundred eighty-six patients who had undergone total gastrectomy were analyzed in regard to pulmonary aspiration. Sixteen patients (8.6%) with recurrent respiratory tract inflammation (r-RTI) and 45 patients (24.2%) with sporadic RTI (s-RTI) were observed. The r-RTI group frequently showed symptoms related to esophageal reflux among the many factors affecting the onset of disease. They were also characterized by marked inflammatory responses with various and atypical clinical courses. The swallowing provocation test showed swallowing disturbances (prolonged latency) in patients with r-RTI. We concluded that the aspiration of esophageal reflux contents was the most important risk factor of recurrent pulmonary complications in patients with total gastrectomy.