Clinical Picture, Radiological Findings, and Physical Examination in Tracheobronchial Foreign Body Aspiration: Which One is More Important?

Abstract

Tracheobronchial foreign body aspiration is more frequent in children between 6 months-3 years of age, whereas it is seen less often in adults. The diagnosis of TBFB aspiration can be delayed in the adult population due to the lack of clinical suspicion. A case of a 56-year-old male patient admitted to the emergency department with a history of aspiration of a piece of carrot 4 hours previously, a cough and stridorous breathing is presented. His physical examination revealed reduced respiratory sounds in the lower zone of the left lung. There was no radiological clue of a tracheobronchial foreign body. Thus, we performed rigid bronchoscopy and found that the left lower lobe basal segment bronchus was almost totally obstructed by a foreign body (carrot) of 1.5x1 cm, which was removed. This was based on the clinical suspicion derived from the history and the physical examination alone. We emphasise that history and physical examination are more important in the diagnosis of organic or non-opaque tracheobronchial foreign body aspiration.