Question:medium
A baby playing was left unattended by the mother develops distress. Identify where the object is [Images show PA and lateral chest X-rays with a round radio-opaque foreign body in the midline]
A baby playing was left unattended by the mother develops distress. Identify where the object is [Images show PA and lateral chest X-rays with a round radio-opaque foreign body in the midline]
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On a PA chest X-ray, a coin lying en face (full circle visible) with the trachea anterior to it on the lateral view localises it to the oesophagus, not the trachea.
Updated On: Jun 23, 2026
- Oesophagus
- Trachea
- Below diaphragm
- GI tract
Show Solution
The Correct Option is A
Solution and Explanation
Clinical context: Child + unattended + distress + round radio-opaque object on CXR = swallowed/aspirated foreign body
Localisation rule for coin on X-ray:
| View | Oesophagus | Trachea |
|------|-----------|---------|
| AP (frontal) | En face -- full circle visible | Edge-on -- linear stripe |
| Lateral | Edge-on -- linear; trachea lies ANTERIOR | En face -- full circle |
In this question:
Common sites of oesophageal impaction (in order):
1. Cricopharyngeus muscle (C6 level) -- most common
2. Aortic arch level
3. Gastro-oesophageal junction
Management: Endoscopic removal under sedation
\[\boxed{\text{Answer: Oesophagus}}\]
Localisation rule for coin on X-ray:
| View | Oesophagus | Trachea |
|------|-----------|---------|
| AP (frontal) | En face -- full circle visible | Edge-on -- linear stripe |
| Lateral | Edge-on -- linear; trachea lies ANTERIOR | En face -- full circle |
In this question:
- PA view: round opaque object (en face) -- suggests oesophagus
- Lateral view: trachea is anterior to the coin -- confirms coin is POSTERIOR = oesophagus
- Object is above the aortic knob = mid-thoracic oesophagus (second common impaction site after cricopharyngeus)
Common sites of oesophageal impaction (in order):
1. Cricopharyngeus muscle (C6 level) -- most common
2. Aortic arch level
3. Gastro-oesophageal junction
Management: Endoscopic removal under sedation
\[\boxed{\text{Answer: Oesophagus}}\]
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