Bronchial foreign body presenting as pneumothorax and pneumomediastinum in a young child

Abstract Pneumomediastinum (PM) and Subcutaneous emphysema (SCE) following foreign body aspiration is very rare. Pneumomediastinum (PM) occurs due to alveolar rupture whereas subcutaneous emphysema occurs if air leak persists. It is benign in nature but in some cases, it might be fatal. Therefore, proper assessment and management is required to limit the life-threatening complications and FB should always be suspected whenever spontaneous PM and SCE is seen. We describe an 18-month-old boy who was presented with cough, fever and respiratory distress to Siddhi Memorial Hospital (for women and children), Emergency Department. On examination, there was decreased air entry over supra-mammary and infra-axillary region on left side of the lung field. He had foreign body in left distal bronchus with PM and SCE with in radiography. The patient was treated with oxygen, antibiotics and planned for bronchoscopy but the child self-expectorated bean seed while coughing. PM and SCE are very rare presentations of foreign body aspiration in children of age less than 3 years and in such circumstances, the possibility of foreign body should be considered.