The Importance of Bronchoscopy in the Recognition of Non-Opaque Foreign Body in Infants and Children.

When the presence of a non-opaque foreign body in a main or lower lobe bronchus is suspected, the following radiographs will be required, in addition to screening in order to note the positive movements of the mediastinum, heart and diaphragm: (1) A postero-anterior view at the end of inspiration; (2) a postero-anterior view at the end of expiration; (3) a lateral view; and (4) occasionally a bronchogram. Radiographs of the normal chest when in full inspiration and full expiration show that the following points can be noted: (1) An increased translucency of both lungs during inspiration ; (2) the position of the heart, mediastinum and the trachea is unaltered and in the mid-line ; (3) the dome of the diaphragm is depressed with inspiration and rises with expiration ; (4) the intercostal spaces are widened with inspiration ; (5) the apices of the lungs are contracted in inspiration ; and (6) a decreased translucency of the lungs in expiration. When one lung is in the condition of' obstructive emphysema,' the affected lung remains hypertranslucent at the end of expiration, due to the trapped air being unable to escape, and in a suspected case of a non-opaque foreign body radiographs in both inspiration and expiration are essential.