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Clinical Problem Solving: Radiology
August 2004

Radiology Quiz Case 1—Diagnosis

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Copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Otolaryngol Head Neck Surg. 2004;130(8):998-999. doi:10.1001/archotol.130.8.998

Because the cause of the patient's recurrent croup was unknown, a diagnostic laryngobronchoscopy was performed. Intraoperatively, the oral cavity, base of tongue, epiglottis, vallecula, larynx, and vocal cords were found to be normal. An FB was noted in the subglottis (Figure 2). The FB appeared to be tightly lodged in the subglottic area, with surrounding inflammatory granulations (Figure 3). On removal, it was identified as a triangular-shaped chicken bone (Figure 4). Because of the chronic inflammation and the edema, both of which were caused by the FB, the subglottic airway was narrowed by 40%. After the FB was removed, the symptoms cleared. The patient recovered uneventfully and had no further respiratory complaints.