Fritz Schneble (Regensburg)  

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21 Months  

N/A  

Thorax-Lung  

physical  

21 month old child. Coughing when eating apple and bread pieces. Following: agitation, cold sweat. Presentation 3 hours after the episode. The clinical examination showed a slight difference in sides with minimally lowered breath sounds on the left side.  

Shifting of a main or lobular bronchus with development of an atelectasis or a bronchial outlet (vent) mechanism.  

<- view X-Ray 1

X-Ray 1: In inspiration, symmetrical ventilation of both lungs. No proof of infiltrates. Normal depiction of the heart and mediastinum.





<- view X-Ray 2

X-Ray 2: In minimal expiration, there is an obvious difference in the transparency of the lungs. Ballooning of the left lung. Mediastinal shifting to the right.


 

Imaging including endoscopy  

The images in expiration proove a bronchial outlet (vent) mechanism on the left side. A bronchoscopy is immediately needed.

Bronchial obstruction due to a vessel anomaly, tumor, or lymph node obstruction.  

In the immediately carried out bronchoscopy, a foreign body (piece of apple) was shown in the left lower-lobe bronchus, which could be removed without problems.

Obvious locally inflamed mucosal lesions.

Uncomplicated clinical course.  

N/A  

N/A  

N/A  

Foreign body aspiration, Bronchial outlet mechanism, foreign body, aspiration, cough, meal, child, childhood, pediatric radiology  

Fritz Schneble. Foreign body aspiration. PedRad [serial online] vol 3, no. 2.
URL: www.PedRad.info/?search=20030214135311