Pediatrics 413392.A 2-year-old boy is brought to the ED shortly after a choking episode.
His parents noted he had been playing with coins on the floor just prior to
the episode. There has been no previous history of fever or runny nose in
the past few days. The parents tried to feed the patient after the episode but
he has been unwilling to take anything orally. On examination, the patient
is calm with stable vital signs and a pulse oximetry of 98% on room air. He
spits in a cup every couple of minutes, but is otherwise in no apparent dis-
tress. His oropharynx is unremarkable and his lungs are without wheezes or
rales. His radiograph is seen below. Which of the following most likely
accounts for the patient’s symptoms?
(Courtesy of Adam J Rosh, MD.)a. Foreign body aspiration
b. Bronchospasm
c. Foreign body ingestion
d. Epiglottitis
e. Allergic reaction