X-ray of focal pneumonia in lower right lung lobe (bottom left of chest in image) due to<unk>  and airway obstruction.The most important aspect of the assessment for a clinician is an accurate history provided by an event witness. Unfortunately, this is not always available. Physical examination A physical examination by a clinician should include, at a minimum, a general assessment in addition to cardiac and pulmonary exams. Auscultation of breath sounds may give additional information regarding object location and the degree of airway obstruction. The presence of drooling and dysphagia (drooling) should always be noted alongside the classic signs of airway obstruction as these can indicate involvement of the esophagus and impact management. Diagnostic Imaging 319x319px Radiography is the most common form of imaging used in the initial assessment of a<unk> <unk>  presentation. Most patients receive a chest x-ray to determine the location of the<unk> <unk> . Lateral neck, chest, and bilateral decubitus end-expiratory chest x-rays should be obtained in patients suspected of having aspirated a<unk> <unk> . However, the presence of normal findings on chest radiography should not rule out<unk>  as not all objects can be visualized. In fact, up to 50% of cases can have normal findings on radiography. This is because visibility of an object depends on many factors, such as the object's material, size, anatomic location and surrounding structures, as well as the patient's<unk>  habitus. X-ray beams only show an object if that object's composition blocks the rays from traveling through, making it radiopaque and appearing lighter or white on the image. This also requires it to not be stuck behind something that blocks the beams first. Objects that are radiopaque include items made of most metals except aluminum, bones except most fish bones, and glass. If the material does not block the x-ray beams it is considered radiolucent and will appear dark which prevents visualization. This includes material such as most plastics, most fish bones, wood, and most aluminum objects. Other diagnostic imaging modalities, such as magnetic resonance imaging, computed tomography, and ventilation perfusion scans play a limited role in the diagnosis of<unk> . Signs on x-ray that are more commonly seen than the object itself and can be indicative of<unk>  include visualization of the<unk> <unk>  or hyperinflation of the affected lung. Other x-ray findings that can be seen with<unk>  include obstructive emphysema, atelectasis, and consolidation. While, x-ray can be used to visualize the location and identity of a<unk> <unk> , rigid bronchoscopy under general anesthesia is the gold-standard for diagnosis since the<unk> <unk>  can be visualized and removed with this intervention. Rigid bronchoscopy is indicated when two of the three following criteria are met: report of<unk>  by the patient or a witness, abnormal lung exam findings, or abnormal chest x-ray findings.
Foreign body aspiration
Pulmonary aspiration
Tracheoinnominate fistula
Intubation granuloma
Tracheal tumor
Exercise-induced laryngeal obstruction
Laryngopharyngeal reflux
Bronchopleural fistula