Impacted Laryngeal Foreign Body in a Child: A Diagnostic and Therapeutic Challenge

Impacted laryngeal foreign body could lead to catastrophic consequences if appropriate diagnostic and therapeutic procedures are not promptly instituted. A case of 4-year-old child who presented with a 4-day history of probable ingestion or aspiration of a pen part and history of occasional noisy breathing on exertion and swallowing is reported. On examination, the child appeared asymptomatic on general examination. CT scan of larynx and chest revealed foreign body in the larynx. A conical plastic foreign body in the laryngotracheal junction was retrieved by rigid bronchoscopy. The asymptomatic nature of the foreign body was related to the presence of a lumen within the foreign body permitting ventilation and the inert nature of the material. The case demonstrates the importance of the history, CT scan in case of suspicion, and the need for urgent bronchoscopy with appropriate anesthetic technique.