Question

A previously healthy child presented with acute – onset dyspnea. A chest X – ray shows unilateral hyperinflation of the lungs. What is true for this patient ? 

• A. Focal area of decreased air entry will be suggestive of foreign body
• B. Flexible bronchoscopy used for removal
• C. In complete obstruction ball and valve mechanism causes hyperinflation
• D. The child has developed acute laryngotracheobronchitis

Answer 1

The Correct Option is C

When a previously healthy child presents with acute-onset dyspnea and a chest X-ray reveals unilateral hyperinflation of the lungs, it is crucial to determine the underlying cause. Such a presentation often suggests a case of foreign body aspiration.

Let's consider the options provided:

• Focal area of decreased air entry will be suggestive of foreign body: While this can be indicative, unilateral hyperinflation specifically suggests a partial obstruction caused by a foreign body, leading to a ball-valve effect.
• Flexible bronchoscopy used for removal: While bronchoscopy can be used to remove foreign bodies, flexible bronchoscopy is not typically the first choice; rigid bronchoscopy is preferred for removal in the case of foreign bodies in children.
• In complete obstruction ball and valve mechanism causes hyperinflation: This is correct. The ball-valve mechanism occurs when a foreign body acts as a partial obstruction, allowing air to enter during inspiration but blocking its exit during expiration, leading to hyperinflation of the affected lung.
• The child has developed acute laryngotracheobronchitis: This suggests a different condition characterized by croup and does not typically present with unilateral hyperinflation on X-ray. 

Therefore, the statement "In complete obstruction ball and valve mechanism causes hyperinflation" is true for this patient.