Radiology of airway foreign bodies in children

Among 91 children with airway foreign bodies there were 10 with radiopaque foreign bodies. Seventy-four of the cases of non-opaque foreign bodies were unilateral. Seventeen had pulmonary consolidation or loss of volume and 33 had a unilateral hyperlucent lung. In 18 of the latter there was unilateral overinflation, but in 15 the hyperlucency was the result of pulmonary vasoconstriction. Twenty-three patients had normal routine inspiration radiographs; in 14 of these fluoroscopy or expiration films were obtained and air-trapping was demonstrated in 13. In twenty-three of the children the diagnosis was delayed. Fifteen of these had normal chest radiographs or unilateral hyperlucency alone. Since normal inspiration chest radiographs are frequently seen in cases of airway foreign bodies even when the diagnosis is delayed, it is strongly recommended that fluoroscopy or expiration films be obtained in any patient where the diagnosis is in doubt.