Aspiration pneumonias involve the alveoli. The literature reports a most frequent involvement of the posterior segments of the upper lobes and the upper segments of the lower lobes. This happens as aspiration occurs with the child in dorsal decubitus, like in most gastroesophageal reflux and vomiting episodes. In other situations, such as tracheoesophageal fistula and lack of motor coordination, other pulmonary segments may be affected(19-21) (Figures 2 and and5).5). In most of cases, chest radiography and EGDS are sufficient to confirm the clinical suspicion; eventually, high resolution computed tomography is useful. Aspiration may result in atelectasis or pneumonia, the latter with or without atelectatic component. The absence of fever suggests pure atelectasis