*9.2.3 Pulmonary aspiration*

Pulmonary aspiration of gastric contents during the gastro-intestinal endoscopic procedures are very common. It may lead to pneumonia and death. Over-sedation, gastro-intestinal bleeding, intestinal obstruction, elderly, and hepatic encephalopathy are the risk factors of pulmonary aspiration. Cough, cyanosis and respiratory distress are the early signs of pulmonary aspiration. If the aspiration is suspected, the procedure should be suspended, head down tilt, left lateral positioning,

suctioning of the fluid from the airway, encouraging patient and chest x ray should be considered [19].
