*3-years-old child with acute onset respiratory distress.
What is the most likely diagnosis?
Answer
Answer: Airway foreign body
Case Discussion:
Scout and CT images demonstrate rightt main bronchus foreign body(FB). Asymmetry in both hemithoraces, with greater volume and lucency to the right due to air trapping.
Children under the age of 4 years are at increased risk of foreign body aspiration, with a slight male predominance.
Most foreign bodies are organic (70-90%), most commonly seeds and nuts. Inorganic foreign bodies can include teeth, coins, pins, pens/crayons, etc.
Aspirated foreign bodies have a predilection for the right tracheobronchial tree, due to wider and steeper structure of the right main bronchus.
References:
1. Passàli D, Lauriello M, Bellussi L et-al. Foreign body inhalation in children: an update. Acta Otorhinolaryngol Ital. 2010;30 (1): 27-32.
2. Martin L. Gunn. Pearls and Pitfalls in Emergency Radiology.