Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Case 89 Thymus simulating mediastinal hematoma
- Case 90 Foreign body aspiration
- Case 91 Idiopathic ileocolic intussusception
- Case 92 Ligamentous laxity and intestinal malrotation in the infant
- Case 93 Hypertrophic pyloric stenosis and pylorospasm
- Case 94 Retropharyngeal pseudothickening
- Case 95 Cranial sutures simulating fractures
- Case 96 Systematic review of elbow injuries
- Case 97 Pelvic pseudofractures: normal physeal lines
- Case 98 Hip pain in children
- Case 99 Common pitfalls in pediatric fractures: ones not to miss
- Case 100 Non-accidental trauma: neuroimaging
- Case 101 Non-accidental trauma: skeletal injuries
- Index
- References
Case 90 - Foreign body aspiration
from Section 8 - Pediatrics
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Case 89 Thymus simulating mediastinal hematoma
- Case 90 Foreign body aspiration
- Case 91 Idiopathic ileocolic intussusception
- Case 92 Ligamentous laxity and intestinal malrotation in the infant
- Case 93 Hypertrophic pyloric stenosis and pylorospasm
- Case 94 Retropharyngeal pseudothickening
- Case 95 Cranial sutures simulating fractures
- Case 96 Systematic review of elbow injuries
- Case 97 Pelvic pseudofractures: normal physeal lines
- Case 98 Hip pain in children
- Case 99 Common pitfalls in pediatric fractures: ones not to miss
- Case 100 Non-accidental trauma: neuroimaging
- Case 101 Non-accidental trauma: skeletal injuries
- Index
- References
Summary
Imaging description
The imaging hallmark of foreign body aspiration is static lung volume that persists over the respiratory cycle [1]. A unilateral hyperlucent lung is often identified but not required (Figure 90.1). In most pediatric patients this is evaluated with bilateral decubitus views in addition to the conventional frontal and lateral projections. Normally the dependent lung should become more opaque with atelectasis on decubitus imaging. In the setting of aspiration, the affected lung either remains lucent on the ipsilateral decubitus view, or does not increase in opacity to the same extent as the contralateral lung due to partial bronchial obstruction.
In older and more compliant patients, expiratory views may be performed in lieu of decubitus projections. Expiration may reveal persistent lucency in the setting of aspiration, while the normal lung should become more opaque.
The majority of foreign bodies are radiolucent [2]. In some cases there is interruption of the air-filled bronchus at the level of the aspirated foreign body, known as the interrupted bronchus sign (Figure 90.2) [3].
Importance
Suspicion of foreign body aspiration on radiographs should prompt an urgent bronchoscopy for retrieval. Delay in diagnosis may result in bronchial rupture, bronchopulmonary fistula, prolonged hospitalization, and chronic or recurrent pulmonary infection [4].
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 322 - 324Publisher: Cambridge University PressPrint publication year: 2013