The parents of a girl aged 1 year and 1 month brought her to the Clinical Centre for Paediatric Medicine after she suddenly began to cough severely while eating peanuts. The initial examination did not reveal any pathological changes: auscultation of the lungs was unremarkable, and the X-ray did not show indirect signs of bronchial obstruction.
Despite the absence of clear changes on the images, in view of the suspected aspiration, the parents were advised to agree to a diagnostic bronchoscopy and were told that the foreign body would not disappear on its own and could cause complications. However, they initially refused the procedure and went home.
That same evening the child’s condition worsened: the cough intensified, her temperature rose, and the parents returned to the centre to see the doctors again. After a repeated examination, the specialists decided to perform a bronchoscopy to clarify the diagnosis and, if necessary, remove the foreign object.
During the endoscopic examination it was found that the peanut was stuck in the lower lobe bronchus of the left lung and was completely covered with mucus. Because the foreign body was lodged in a very narrow segment, it was not possible to use standard optical forceps.
The paediatric surgical team used an unconventional technique: through the bronchoscope they introduced fine endoscopic forceps, which are usually used during fibroscopy. First, the doctors removed the mucus, and then carefully grasped and extracted the peanut from the bronchus. The entire bronchoscopy lasted about an hour and a half.
After removing the foreign body, the medical team restored the bronchial patency, carried out sanitation of the bronchial tree and cleared the airways of mucus. The very next day the young patient was discharged home for further outpatient follow-up.
The operation was performed by paediatric surgeon Oleksandr Kolodii, anaesthetist Halyna Kishko and assistant, junior doctor-intern Olha Kononova.
Doctors remind parents that whole nuts should not be given to children under three years of age, and food must be age-appropriate and safely prepared. Small objects, batteries, toy parts and foods that are easy to choke on must be kept out of children’s reach.
Doctors emphasise that nuts and other organic foreign bodies are often not visible on X-ray, and sometimes no changes can be detected when listening to the lungs. In such situations, bronchoscopy is the most accurate diagnostic method. If a child suddenly starts coughing or choking after eating or playing with small objects, a doctor should be consulted immediately, as even if the symptoms temporarily ease, a foreign body may remain in the airways and cause serious complications.