pulmonary aspiration epidemiology and risk factors objective to determine the epidemiology and risk factors for gastric aspiration in a french university hospitalmethods files were prospectively selected from a computer database of rare and severe complications between january 2002 et april 2007 medical files were then analyzed according to a predetermined list of specific itemsresults forty patients suffered from gastric aspiration among 117 033 anaesthesias 4 medical files lost 31100000 global incidence all occurred during general anaesthesia 83 at induction 8 in the recovery room half of the cases for emergent cases 15 of emergency in emergency the incidence of gastric aspiration increased by 45 only 14 patients 39 had a full stomach 17 47 other risk factors and five 14 none a rapid inductionintubation sequence with a sellick manoeuvre was performed in only 50 of patients with a full stomach and in 236 of those with other risk factors gastric aspiration occurred in three patients with a laryngeal mask aspiration was associated with clinical symptoms in 21 patients eleven patients developed an ards 5 deathsdiscussion the incidence of gastric aspiration was slightly higher in this series than in other published series rapid inductionintubation sequence with sellick manoeuvre is not always used in patients with a full stomach restraining this technique only to these latter patients does not guarantee practitioners to avoid the risk of gastric aspiration there is a large need to define which patients are at higher risk of gastric aspiration by national recommendations of clinical practice