The study was an observation by a practicing Pediatrician in small group of patients to communicate the message that left sided bronchial FBs may be equally common. All the FBs were removed by a rigid bronchoscope which is still preferred in children. There were no deaths.

1. There were 3 crainal FB and their ages were 10 months, 18 months and 5 years. the first two. infants had inhaled peanuts and presented within 24 hours of accident. the third one was a 5 years old child who had aspirated a tamrind seed. The chest radiograph showed much.. hyper inflated lung fields with both the diaphragms pushed downwards. All the three cases re- covered after emergency bronchoscopic removal of FB. The site of FB in Sharma et al.(1) series was larynx g..5%, trachea 5.7% and either of the bronchi 85% with right bronchus being the commonest site (58.5%). In the series of Mantel et al.(2) 56% of aspirated FB were localized in the right bronchial system, 39% in the left and 5% were subglottic or trachea.

2. The other two cases with a definite history of aspiration of peanuts and radiographic evidence refused bronchoscopy.

3. Only one child aged 2 years had inhaled a radio-opaque (chalk) FB into left bronchus. Persistent right mid-lobe consolidation was present in the one case doe to aspiration of shankar peda, which was re- moved successfully.

4. Factors like age less than two years and small smooth FB influence the localization of FB into the left bronchus as ob- served in this study. In a child under the age of three, both the main bronchi come off the trachea at equal angles unlike the angulation in the adults. Most of the FB are aspirated into the right bronchus be- cause of its anatomical configuration. The protective mechanism of respiratory tract (Behchic cough) easily expells a loose small FB upwards from the right bronchus. At the carina level, the FB is sucked into the left bronchus due to lower pres- sure and fast rush of air flow in it. The left bronchus retains the FB because of its long narrow and tortuous nature(3).
 

J .K. Lakhani,
Consultant Pediatrician,
Gadag 582101, Kamataka, India.