PMC5502936_01
Hazy opacity projecting over the right heart border on presentation to ED.
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Initial chest X-ray (CXR) showed patchy opacity in the right middle lobe (Figure 1).
Interval development of bilateral diffuse hazy opacities suggestive of pulmonary edema (45 min after Figure 1).
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A repeat CXR to confirm the position of endotracheal tube showed interval development of bilateral, diffuse, hazy ground glass opacities suggestive of pulmonary edema (Figure 2).
On bronchoscopy, multiple pieces of nuts found in the distal trachea at the level of carina were removed entirely.
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Multiple pieces of nuts were found in the distal trachea at the level of carina (Figure 3), occluding the airway completely.
Further worsening of pulmonary edema after removal of foreign body (21/2 h after Figure 2).
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A repeat CXR (Figure 4) 21/2 h after initial CXR showed worsening pulmonary edema.