A 3-year-old child presents with sudden onset coughing, choking, and unilateral wheeze. Chest X-ray in expiration shows air trapping (hyperinflation) of the right lung. The most likely site and nature of the foreign body is:
- A Laryngeal inlet; inorganic metallic object
- B Right main bronchus; organic (peanut/seed) ✓
- C Left main bronchus; organic material
- D Trachea at the carina; smooth flat object
Explanation
The right main bronchus is more commonly involved in bronchial foreign body aspiration in children (and adults) because it is wider, shorter, and more vertically oriented than the left. Air trapping on expiratory films (or mediastinal shift away from the affected side) is the hallmark of a ball-valve obstructing bronchial foreign body. Organic material (peanuts, seeds, vegetable matter) is most common in children under 5, as it causes local inflammation, swelling, and secretions making removal more urgent. Rigid bronchoscopy under general anaesthesia is the definitive treatment.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.