Pneumothorax, pneumomediastinum and subcutaneous emphysema due to foreign body aspiration (FBA) are rarely encountered in clinical practice. Epidural emphysema or pneumorachis as it is known is an even rarer condition associated with FBA reported infrequently in literature. We present here, a rare case of FBA encompassing features of all of the above mentioned entities in a preschooler who presented with symptoms of acute respiratory distress following a respiratory tract infection of 2 weeks duration. A possibility of foreign body aspiration was considered on the basis of her clinical and radiological investigations suggesting hyperinflation and collapse at different places with air leaks leading to the above complications. Accordingly, a diagnostic bronchoscopy was performed which revealed a peanut in the left main bronchus which was successfully extracted leading to resolution of symptoms in the child.

Key words: Foreign body aspiration; Pneumothorax; Pneumomediastinum; Pneumorachis; Epidural emphysema; Bronchoscopy.