Aspiration of ear plug into the respiratory tract

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Before the development of roentgenography, diagnosis of aspirated foreign bodies in air passages was suspected from the history and confirmed by physical examination. With improvement in the technical capabilities of roentgenography, clinicians began to rely more and more on the roentgenogram to make the diagnosis, especially in cases involving radiopaque foreign bodies.1 Jackson2 in the late 19th and early 20th centuries compiled an impressive collection of foreign bodies which he had extracted from the air passages and the upper esophagus. The physical principles involved in the various degrees of obstruction of air passages, and the subsequent correlative physical findings are described by Nelson.3 Caffey4 gives a detailed explanation of the physical principles involved in the roentgenographic changes. The present case demonstrates two points. First, the physician should be alert to the possibility of a foreign body when there is a history suggestive of aspiration, or when intermittent unilateral wheezing develops in a previously well child, even if a routine chest roentgenogram has been reported as normal. Second, it emphasizes the importance of inspiratory and expiratory roentgenograms in ruling out a foreign body in the tracheobronchial tract.

Case report

A 7-year-old girl was playing with a transistor radio with a loose ear plug when she began coughing, and was unable to locate the ear plug. The patient was taken at that time to a local hospital where a roentgenogram was interpreted as normal with no evidence of radiopaque foreign body. The patient had intermittent wheezing after that but never complained of



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