67 years old, Male known case of COPD; presented with complaints of  recurrent cough episodes not relieved after taking medications with history of suspected foreign body aspiration 2 months back.

Evaluated with CXR. Right mid zone opacity reported by the radiologist. Other blood workup CBC, LFT, KFT were normal.

In the view of suspected foreign body patient was posted for bronchoscopy. Flexible fiberoptic bronchoscopy was done –

1. Foreign body “betel nut” localized in Rt. Middle lobe.
2. Foreign body removal was done in deep sedation using Rat tooth forceps
3. Post procedure check bronchoscopy done showing presence of small granulation tissue.
4. Procedure was done within 10 minutes.
5. Patient shifted to ward for monitoring.

Foreign body aspiration is an uncommon entity in adults. Foreign bodies can either be organic (e.g. peanuts, peas) or inorganic (e.g. plastic caps, pins, screws, nails, teeth)

Clinically, patients may present either with acute respiratory failure requiring urgent intervention or with recent onset of respiratory symptoms, including breathlessness, wheezing, coughing, and expectoration.

The radiological manifestations of foreign body aspiration include either direct visualization of the foreign body in the case of radiopaque foreign bodies or indirect signs (representing airway obstruction) in the form of non-resolving pneumonia, atelectasis, unilateral hyperinflation, or localized bronchiectasis, especially in those with organic foreign bodies.

In children,