An unusual case of occult bronchial foreign body in a 9 years child: a stone from seashore

ABSTRACT
Pediatric tracheobronchial foreign bodies (PTBFBs) remain a significant cause of childhood morbidity and mortality. Because physicians do not always obtain a history of aspiration and the signs and symptoms of a PTBFB are nonspecific, diagnosis may be delayed, increasing the risk of complications when the foreign body is removed. Flexible fiberoptic and rigid bronchoscopy are often used in tandem to identify and remove PTBFBs. A 9-year-old boy comes to our observation because of persistent shortness of breath at rest and easy fatigability in the last 3 months. The symptom’s onset was traced back to a febrile episode two months ago. At that time, the child was admitted to another hospital and discharged with the diagnosis of right bronchopneumonia with radiographic evidence of a radiopaque oval formation referred to a calcified hilar lymph node. By performing a chest CT scan, we posed the suspicion of an endobronchial foreign body, which was confirmed and therefore removed by rigid bronchoscopy with rapid improvement in the child’s clinical conditions.

IMPACT STATEMENT
This case report underlines the importance of clinical history in diagnosing aspirated foreign bodies despite unusual age and negative
first-level investigations and bronchoscopy’s diagnostic and therapeutic role.

Received: May 23, 2023
Accepted: June 5, 2023
Published: Dec 1, 2023