A child with respiratory distress having unilateral obstructive emphysema and contralateral opaque hemithorax on chest radiograph: Role of multi‐detector computerized tomography with multi‐planar reconstruction and virtual bronchoscopy

Abstract

We describe a case of mucus plug in the right main bronchus with ipsilateral obstructive emphysema and contralateral opaque hemithorax in an 18-month-old girl who presented with respiratory distress. The role of multi-detector CT scan with multi-planar reconstructions and virtual bronchoscopy is highlighted.

Tracheobronchial Foreign Bodies in Children: Imaging Assessment

“…The incidence of mucous plugs in children without the predisposing factors is not known and probably low. 28 There was a reported incidence of mucous plug in 3% of children in a study of 85 children who underwent bronchoscopy for various reasons. 28 A mucous plug in the airway can mimic a foreign body.…”

“…28 There was a reported incidence of mucous plug in 3% of children in a study of 85 children who underwent bronchoscopy for various reasons. 28 A mucous plug in the airway can mimic a foreign body. 27 Mucous plug can cause sudden respiratory distress or chronic symptoms like a foreign body.…”

“…29 However, a case of unilateral obstructing emphysema and contralateral opaque hemithorax has been described in which the dual pathology was most likely caused by a shifting or migrating mucous plug. 28 It may not be possible to make a definite diagnosis of mucous plug using imaging techniques, including CT. Some features suggestive of mucous plug on CT scan are relatively low density of the mucous plug with an attenuation value of 0-10 Hounsfield Units, presence of a linear branching pattern, and possibly absence of air trapping 29 (Fig.…”

Surprise Foreign Body Aspiration with Pistachios in a Patient with Cystic Fibrosis with Persistent Atelectasis on Chest Radiography

“…During the examination, there was a decrease in respiratory sounds in the lower zone of the right lung and widespread crepitant rales more pronounced in the lower zone of both lungs. His complete blood count was found to be as follows: white blood cell: 17.3 × 10 9 /L, neutrophil: 13.1 × 10 9 /L, and C-reactive protein: 110 mg/L (0-5). Pulmonary radiography showed an atelectasis area and infiltration in the lower zone of the right lung.…”