Tracheal Foreign Bodies Are Radiographs Misleading?

Objective: This study aimed to highlight the pitfalls of relying on radiographs in identifying potentially life-threatening upper airway foreign bodies in children. Design: Case series. Methods: A review of the medical records of 2 cases of upper tracheal foreign body was performed. Results: Both patients presented with biphasic stridor refractory to medical therapy and chest radiographs that were normal. One patient had a history of witnessed aspiration while the other did not. Both patients were managed by endoscopic removal of foreign bodies in the operating room and experienced no long-term sequelae related to this event. Conclusions: Tracheal foreign bodies present a diagnostic challenge, and patients may fail to manifest radiographic abnormalities. In patients with a characteristic history and biphasic stridor, an endoscopic evaluation of the airway should be performed to avoid potentially devastating consequences.