Aspiration pneumonia due to gastroesophageal reflux is a serious and frequently encountered problem in pediatrics and pediatric surgery.1-3 Occasionally aspiration may be silent and minimal, yet chronic unexplained respiratory symptoms may appear.4

A number of authors have reported another cause of aspiration in children, namely aspiration of gastric juice while the child is receiving mechanical ventilation by means of a respirator, especially if an uncuffed endotracheal tube is used.5-7

Nasogastric tubes are frequently used in pediatrics and pediatric surgery. It was found that the incidence of postoperative pneumonia in adults was 10 times higher in patients in whom nasogastric tubes were used.8

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