A 16-month-old infant girl was transferred to Arkansas Childrens Hospital from an outlying clinic with a diagnosis of severe "asthma." For four weeks prior to admission, she had been followed up for recurrent right lower lobe "pneumonia" (Fig 1). One day prior to admission, severe stridor developed, and progressed to cyanosis and two respiratory arrests that abated with endotracheal intubation but stridor persisted. On admission, she was noted to have inspiratory stridor, with a prolonged expiratory phase. After failing to respond to the usual acute medical treatment of asthma, the patient was extubated and a soft-tissue lateral roentgenogram of the airway was taken (Fig 2).
Denouement and Discussion
Tracheal Foreign Body: (An Almond)
This case of a tracheal foreign body (an almond) illustrates the treacherous nature of a foreign body at this site, especially one that can move from one part of the tracheobronchial tree to another. Our patient experienced two respiratory arrests that were due to the
Young LW, Seibert RW, Seibert JJ. Radiological Case of the Month. Am J Dis Child. 1979;133(7):749–750. doi:10.1001/archpedi.1979.02130070085019