Occult Foreign Body Aspiration in a Child with Normal Radiographs

Background Foreign body aspiration (FBA) is a significant cause of morbidity and mortality in young children and may present with subtle or nonspecific respiratory symptoms. Case Presentation We report a case of a 2-year-old girl who presented following a choking episode while eating chicken. Initial and repeat chest radiographs were unremarkable. However, persistent bilateral rhonchi were noted on auscultation, with reduced air entry over the right lung. Due to high clinical suspicion, rigid bronchoscopy was performed under general anesthesia, revealing two fragments of chicken bone lodged in the right main bronchus. These were successfully removed. The patient recovered uneventfully and was discharged in stable condition. Conclusion This case highlights the importance of maintaining a high index of suspicion for foreign body aspiration in children, even when radiographic findings are normal. Early bronchoscopic intervention remains essential to prevent complications.