Foreign Body Aspiration: Imaging Aspects

  • Benjamin Z. Koplewitz
  • Jacob Bar-Ziv
Part of the Medical Radiology book series (MEDRAD)


Foreign body aspiration is the most frequent pediatric domestic accident, and has serious and sometimes fatal sequelae. Most cases occur under the age of 4 years. The history of choking followed by persistent cough is the most reliable clue for the diagnosis, but many patients present with various nonspecific clinical symptoms. When the history of a foreign body aspiration is definite, bronchoscopy is the modality of choice for both diagnosis and management. In the absence of such a history diagnosis can be overlooked, and many children present with unresolved pneumonia, atelectasis, or other complications. The role of the radiologist in such cases is not only to confirm a clinically suspected diagnosis, but also to suggest the diagnosis in patients with nonspecific clinical symptoms and radiologic features that could be related to long-standing foreign bodies. Many clinical and imaging findings are the result of a one-way obstruction mechanism. A normal inspiratory chest radiograph does not rule out a foreign body. Expiratory films are important to demonstrate air-trapping. The high kilo-voltage (kV) copper filter technique is valuable for demonstrating a nonopaque foreign body, and fluoroscopy can be very useful. Computed Tomography (CT) has become more valuable by virtue of its wide availability, high resolution, and the multiplanar, three-dimensional and additional image reconstruction capabilities. CT can indicate the exact location of a foreign body, suggest alternative diagnoses, and can demonstrate any associated complications. The role of other imaging modalities is not as well established. An understanding of the mechanisms of obstruction and their resultant clinical and imaging manifestations, can lead to earlier diagnosis and lower the complication rate. This chapter discusses imaging techniques and findings related to the various types and mechanisms of obstruction and to the complications of foreign body aspiration.


Foreign Body Primary Ciliary Dyskinesia Foreign Body Aspiration Esophageal Foreign Body Bronchial Foreign Body 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Prof. C. Springer and Prof. B.S. Slasky for reviewing the manuscript; Prof. P. Mogle for his comments and for the contribution of the case described in Fig. 19; Prof. J. Lucaya for the cases presented in Figs. 56, 10, 12, 1416; Prof. J. Strife for the case described in Fig. 18; and Mr. E. Koplewitz and Mrs. B. Koplewitz for their editorial comments and their continuous support.


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© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Medical ImagingHadassah-Hebrew University Medical CentreJerusalemIsrael

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