After initial life saving measures, what is appropriate imaging for a suspected foreign body aspiration?

Depending on the age/size of the child, a chest radiograph is usually the first imaging exam.

It is helpful to know that you are worried about an ingested or aspirated object because I can look for secondary signs of bronchogenic obstruction, if it is radiolucent.

The overall appearance of the lungs or subtle mediastinal shift can help find the cause. Also, real time fluoroscopy can be useful to see paradoxical movement. Even with a clearly visible, radio-dense object these supporting finding are helpful to determine the degree of obstruction.

In short – it will be a team effort with the radiologist.  Tell me your concern and I can let you know if I see any of the subtle findings.

Of course, the team will expand to include a bronchoscopist if there is persistent clinical concern, even in negative imaging. Direct visualization is hard to beat.

Important: a thin watch battery or 2 thin disc magnets presents significant additional worry for further mucosal damage. It is important to differentiate them from a coin and you can use my experience to help you and your patient.

Educational purposes for licensed providers.

Note to Patients:Radiology is a very large and ever changing field and this post is to help your provider.  When combined with a thorough history and physical exam, this information can be very useful.  Your provider is best suited to answer specific questions regarding this post.A provider is usually a Nurse Practitioner, Physician Assistant or Medical Doctor.

Of course, this is not a substitute for medical care.