Presentation
History of choking on piece of apple.
Patient Data
Right lung hyperinflated lung with deep sulcus sign and increased in both decubitus views indicating valve mechanism by foreign body obstruction. The trachea and mediastinum show normal in appearance. No hilar or mediastinal lymph nodes detected. Pulmonary vascular markings and hila are normal. The costo-diaphragmatic recesses are clear. Cardiothoracic ratio within normal range. Thymus is visualized and normal for age. The visualized bones are normal. The soft tissues of the chest wall are normal. The visualized part of the abdomen is unremarkable.
Conclusion:
Right lung hyperinflated with deep sulcus sign and increased in both decubitus views indicating valve mechanism by foreign body obstruction.
Case Discussion
The patient underwent bronchoscopy, found to have inflamed mucosa and apple puree at the carina and entrance of the right upper bronchus for which lavage was performed. He was admitted for overnight observation and continued on post-op aspiration prophylaxis with oral augmentin.
By morning he was doing clinically well. Breathing comfortably on room air, no complaints. Taking good oral intake. Afebrile.
Special thanks to:
- Dr Ajay Prashant Dsouza (Consultant and Head of Radiology)
- Dr Muhammad Anwar (Consultant Radiologist)
- Dr Elham El Gably (Consultant Radiologist)
- Jukha Shater Ali Al Badawi (Radiology Manager)
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