[size=20px]A 2-year-old boy presents to the emergency department after his mother noticed him coughing intermittently after eating peanuts. He is currently saturating appropriately on room air and hasn’t been coughing since his arrival. Chest x-ray is unremarkable. What would be the best next step for further evaluation?

 

A Monitor the patient clinically without further imaging

 

B Obtain an MRI with sedation

 

C Perform a low-dose, non-contrast CT scan without sedation

 

D Proceed urgently for rigid bronchoscopy[/size]

C

C

c

C

Edited January 7, 20242 yr by Audrey

C

A

D

B

Edited January 7, 20242 yr by Amal Adam

A

A

A

A

D

this is sufficient history to suspect FB inhalation , x ray changes May takes time before appearing

thus bronchoscopy should be performed

A

A

C

Edited January 8, 20242 yr by dresramermer

D

correct answer

C Perform a low-dose, non-contrast CT scan without sedation

 

Recent studies have shown that CT imaging has a high sensitivity and specificity for the diagnosis of foreign body aspiration (FBA) in pediatric patients. While rigid bronchoscopy remains the gold standard for situations with high-suspicion for FBA, CT imaging should be considered in low-suspicion situations when patients are in no respiratory distress and chest radiographs are unremarkable. If a CT scan is obtained, low-dose radiation protocols without sedation or contrast are recommended.

 

D diagnosis and treatment .. gold choice