Nearly missed laryngeal foreign body

Area of Science:

• Pediatric Emergency Medicine
• Radiology
• Otolaryngology

Background:

• Foreign body ingestion and aspiration are common pediatric emergencies.
• Diagnosis relies on history, physical exam, and radiography to minimize radiation exposure.

Observation:

• A 3-year-old presented with asymptomatic ingestion of magnetic beads.
• Initial chest and abdominal X-rays identified beads in the abdomen.
• Suspicion of laryngeal foreign bodies arose from closer inspection of initial X-rays.

Findings:

• A dedicated neck X-ray revealed two magnetic beads lodged bilaterally around the epiglottis.
• These laryngeal foreign bodies were nearly missed due to lack of upper airway obstruction symptoms.
• Initial radiography failed to detect the laryngeal beads.

Implications:

• This case underscores the need for comprehensive "nose to rectum" imaging in pediatric foreign body evaluation.
• Missed upper airway foreign bodies can have severe consequences.
• Radiologists and clinicians must maintain high suspicion for occult foreign bodies, even in asymptomatic children.