Pneumothorax following bronchial foreign body aspiration in a 5-year-old child: A case report

Introduction Pneumothorax is a rare complication of tracheobronchial foreign body aspiration in children and may obscure the underlying diagnosis, making timely recognition and management challenging. Case presentation A previously healthy 5-year-old boy presented with severe respiratory distress and cyanosis four days after aspirating a roasted grain, having had an initial normal chest radiograph at a primary care center. On arrival at our hospital, he had unilateral decreased air entry and wheezing over the right hemithorax, and repeat imaging revealed a large right-sided pneumothorax with ipsilateral lung collapse but no visible foreign body. Emergency needle decompression and right-sided tube thoracostomy resulted in rapid clinical improvement, and subsequent rigid bronchoscopy enabled complete removal of an organic foreign body lodged in the right main bronchus. The pneumothorax resolved gradually with ongoing chest tube drainage, and the child was discharged without residual respiratory symptoms, with a normal chest radiograph at 1-month follow-up. Conclusion Foreign body aspiration should be considered in the differential diagnosis of young children who develop pneumothorax.