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Foreign body aspiration

Case contributed by Naim Qaqish
Diagnosis certain

Presentation

Choking event witnessed 2 days ago with peanut. Later developed cough and fever.

Patient Data

Age: 1 year
Gender: Male

Chest

x-ray

The heart is normal in size and shape.

Hila and mediastinum appear normal.

The left lower lobe appears hyperinflated with increased density of the upper zone possibly due to hyperinflation. 

No evidence of radio-opaque foreign bodies, Further evaluation is advised to exclude radiolucent foreign bodies.

Clear right lung and costophrenic angles.

Case Discussion

Most inhaled foreign bodies are organic and are not seen on chest x-ray. Clinical suspicion needs to be high. The most common findings are unilateral (exclusively involve the lower lobes, with the right being the most commonly affected side) and distal obstructive emphysema. If long-standing, recurrent or non-resolving consolidation or segmental collapse may be seen.

Witnessed by mother choking event 2 days ago with peanut, later developed cough and fever. A chest x-ray was requested to rule out aspiration or chest infection. Radiographic findings of airway foreign body aspiration were seen and confirmed by bronchoscopy retrieval. 

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