Presentation
Young mother happily getting ready to go out, holding scarf pin in mouth, accidentally inhaling it.
Patient Data
The patient presented without respiratory symptoms so the physician assumed it would be ingested.
A hyperdense linear structure (metallic density) is superimposed over the right lower lung zone. Subsequently, a chest x-ray was obtained for better assessment.
Bold yellow arrow points to the previously mentioned hyperdense structure.
On frontal chest radiograph, the hyperdense structure is clearly visualized superimposed over the right lower lung with its sharp edge pointed upwards. No evidence of hyperinflation or lung collapse, in-keeping with patient being asymptomatic.
On the lateral radiograph, the structure seems to be in the bronchus intermedius.
Case Discussion
Foreign bodies can be detected easily if they are metallic in nature. However, a radiolucent object is harder to identify on plain radiograph, and a CT scan with multiple window settings is useful in those cases.
As the right main bronchus is steeper and larger in comparison with left main bronchus, it is more prone for foreign body impaction. In this patient, urgent flexible bronchoscopy was successfully performed to retrieve the foreign body, which was indeed a scarf pin.
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