Migratory pushpin in the tracheobronchial tree

Description

A healthy 10-year-old boy presented to the emergency department, with a 3-day history of cough and odynophagia, which started after eating squid. On examination, he had decreased breath sounds in the lower half of the right lung. The physical examination was otherwise unremarkable. Chest X-ray showed a consolidation of the right lower lobe with small pleural effusion, and a foreign body in the right bronchus (figure 1A). The patient was admitted for antibiotic treatment and bronchoscopy, but had a sudden onset of coughing with respiratory distress, pale skin and cold extremities, for a few seconds. A subsequent chest X-ray performed after this episode showed that the foreign body had migrated to the left bronchus (figure 1B). Rigid bronchoscopy revealed a pushpin in the left main bronchus, which was removed. Recovery was uneventful. Follow-up X-ray was normal.

Figure 1

(A) Chest radiograph of...

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