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Paint in the Pipe: An Unusual Foreign Body. BACKGROUND: Foreign bodies in the airway can be a diagnostic and therapeutic challenge. CASE CHARACTERISTICS: 30-month-old girl with complaints of noisy and fast breathing following fall over a pile of sand. Sand was suctioned out by direct bronchoscopy. The child improved initially but condition worsened in next four days with marked stridor and wheeze. OBSERVATION: Imaging revealed elongated sharp radiodense opacity in the cervical region, suggestive of foreign body. At repeat bronchoscopy, paint material was removed from the airway, leading to recovery. MESSAGE: Paint material mixed in the sand can adhere to the walls of the airway, and cause persistent symptoms of obstruction.