In a child with sudden dysphagia after swallowing a foreign object, if the object lodges in the right main bronchus, which finding would you expect?

In a child with sudden dysphagia after swallowing a foreign object, if the object lodges in the right main bronchus, which finding would you expect?

• A. Retrosternal chest pain with crepitus
• B. Tracheal deviation toward the affected side due to atelectasis
• C. No respiratory findings
• D. Hematemesis

Answer: (B)

When a foreign body blocks a main bronchus, the lung on that side can no longer be ventilated properly, leading to collapse of that portion of the lung (atelectasis) and a loss of volume. With volume loss, the mediastinal structures—like the trachea and the rest of the mediastinum—shift toward the side of the collapse. Since the object has lodged in the right main bronchus, the right lung collapses and the trachea moves toward the right. The right main bronchus is more vertical and shorter than the left, so aspirated objects are more likely to lodge there, making tracheal deviation toward the right a classic sign of right-sided obstruction and resulting atelectasis. Retrosternal chest pain with crepitus would suggest air from a rupture (pneumomediastinum or subcutaneous emphysema), not simple obstruction with atelectasis. No respiratory findings or hematemesis don’t fit the expected physiology of bronchial obstruction causing unilateral collapse and mediastinal shift.

When a foreign body blocks a main bronchus, the lung on that side can no longer be ventilated properly, leading to collapse of that portion of the lung (atelectasis) and a loss of volume. With volume loss, the mediastinal structures—like the trachea and the rest of the mediastinum—shift toward the side of the collapse. Since the object has lodged in the right main bronchus, the right lung collapses and the trachea moves toward the right.

The right main bronchus is more vertical and shorter than the left, so aspirated objects are more likely to lodge there, making tracheal deviation toward the right a classic sign of right-sided obstruction and resulting atelectasis.

Retrosternal chest pain with crepitus would suggest air from a rupture (pneumomediastinum or subcutaneous emphysema), not simple obstruction with atelectasis. No respiratory findings or hematemesis don’t fit the expected physiology of bronchial obstruction causing unilateral collapse and mediastinal shift.