Pneumothorax in a Neonate after Foreign Body Ingestion

A 5-day-old male neonate was referred for removal of foreign body. Baby had accidentally ingested a gold finger ring presented to her by grandmother. Baby was brought to outside hospital in stable clinical condition. Initial Xray neck and chest showed radio-opaque foreign body at level of cricopharynx. Baby was posted for rigid esophagoscopy under anesthesia. But foreign body was not found in the esophagus. X-ray was repeated on table under C-ARM guidance which showed foreign body in stomach. Due to non-availability of flexible endoscope baby was referred to our hospital. Baby was found to have tachypnea on admission. Repeat chest X-ray showed pneumothorax on right side along with radio-opaque foreign body in stomach (Fig. 1). Intercostal tube was put and baby was kept under close observation. Baby improved symptomatically. Definite cause for pneumothorax could not be found. Perforation at level of cricopharynx due to rigid endoscopy may be postulated. Baby was kept nil by mouth for 6 days and oral feeds were gradually started. Baby passed ring spontaneously on 7th day of hospital admission.