A 2-year-old child is brought with sudden onset choking and stridor while playing with small toys. A lateral neck X-ray shows a radiopaque foreign body at the level of C6. The most appropriate investigation to guide definitive management is:

• A CT neck with contrast
• B Flexible nasopharyngoscopy
• C Rigid bronchoscopy ✓
• D MRI neck without contrast

Explanation

In a child with suspected airway foreign body (sudden choking, stridor, cyanosis), rigid bronchoscopy is both the diagnostic and therapeutic procedure of choice. It allows direct visualization and removal of the foreign body under general anesthesia. CT scan may be done for non-radiopaque or atypical presentations but should not delay bronchoscopy when clinical suspicion is high. A foreign body at C6 level is at the level of the subglottis/upper trachea.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.