Question
A 2-year-old child presents to the emergency department with respiratory difficulty. A chest X-ray shows hyperinflation of the right lung, while the left lung appears normal. Which of the following is the correct statement?
| A. |
Decreased air entry on a particular part of auscultation is suggestive of a foreign body
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| B. |
Removal by flexible bronchoscopy is the treatment of choice (TOC)
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| C. |
Complete obstruction at the bronchus can cause hyperinflation of the lung due to the ball-valve effect
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| D. |
Acute tracheobronchitis
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Show Answer
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Correct Answer » A
Explanation
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|
This presentation strongly suggests Foreign Body Aspiration (FBA) in a child.
Typical features:
- Sudden respiratory distress
- Unilateral hyperinflation on X-ray
- Asymmetric breath sounds
Most Common Site ➡ Right main bronchus
Reason:
- Wider
- More vertical
- Shorter
In foreign body aspiration, a partial bronchial obstruction creates a ball-valve effect:
- Air enters during inspiration
- Air cannot exit during expiration
- Leads to air trapping and hyperinflation
However, complete obstruction causes lung collapse (atelectasis), not hyperinflation.
Reason to rule out other options
B. Flexible bronchoscopy is treatment of choice
In children: Rigid bronchoscopy is the treatment of choice.
Reasons:
- Better airway control
- Allows removal of foreign body
Flexible bronchoscopy is mainly diagnostic, not the preferred therapeutic method.
C. Complete obstruction causes hyperinflation
Hyperinflation occurs due to partial obstruction (ball-valve mechanism).
Complete obstruction → atelectasis (collapse).
D. Acute tracheobronchitis
This condition causes:
- Diffuse symptoms
- Bilateral findings
Not unilateral hyperinflation.
