Right lower lobectomy following inhalation of a toy traffic cone.

Obstruction of the tracheobronchial tree frequently occurs in children due to a lack of adequate dentition and immature swallowing coordination.1,2 This contrasts obstruction in adults which is caused by a failure of airway protection mechanisms due to neurological disorders and trauma.1 Obstruction has three clinical stages: choking and shortness of breath, an asymptomatic phase then a complication stage.2 The composition of the foreign matter determines the stage. Organic materials cause a severe mucosal inflammatory reaction and granulation tissue may develop over several hours. This causes subsequent swelling and partial obstruction warranting immediate clinical intervention. In contrast, inorganic materials can remain asymptomatic for longer periods of time unless the distal airways are compromised. This presents a therapeutic challenge even though two-thirds of objects lodge in main stem bronchi rather than distal bronchi.1,2 Complications of undetected foreign bodies include unresolved pneumonia and abscess formation, fibrosis and bronchiectasis.1 Our case is of a long forgotten toy traffic cone aspirated during childhood that remained undetected for 40 years.