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Abstract
Purpose
Tracheal bronchus is an aberrant bronchus arising from tracheal wall above the carina. Most cases of tracheal bronchus are asymptomatic, so they are diagnosed incidentally. Tracheal bronchus may be associated with other anomalies. The aim of this study is to evaluate the clinical characteristics of tracheal bronchus.
Methods
This study was conducted on 19 children who were diagnosed as tracheal bronchus by the chest computed tomography from January 2000 to December 2011. Based on the medical record, clinical features, such as symptoms, radiologic findings, combined anomalies were evaluated retrospectively.
Results
The age at diagnosis was ranged from 2 day to 14 years (mean, 51 months). Among the 19 children, twelve children (63.2%) were boys and seven children (36.8%) were girls. Eighteen children (94.7%) had right-side tracheal bronchus and one child (5.3%) had left-side tracheal bronchus. Displaced type were fourteen children (73.7%), supernumerary type were five children (26.3%). Thirteen children (68.4%) had no respiratory symptoms, but five children (26.3%) had persistent cough and four children (21.1%) had recurrent wheezing. Combined congenital abnormalities were present in seventeen children (89.5%), including congenital cardiovascular anomaly (n=14, 73.7%), trachea-esophageal fistula (n=3, 15.8%), Down syndrome (n=2, 10.5%).
Conclusion
The patients with tracheal bronchus had not severe respiratory symptoms, but had many combined anomalies. So, it is necessary to consider the presence of tracheal bronchus in children with respiratory symptom, like recurrent wheezing, and to evaluate clinical significance, like combined anomaly, in tracheal bronchus patients. The limitation of this study is that the study group includes many cardiovascular disease patients (84.2%).
Figures and Tables
Fig. 1
Tracheal bronchus. (A) Right-side tracheal bronchus. Coronal image in 5-month-old boy shows right upper lobe bronchus arising from carina. (B) Left-side tracheal bronchus. Coronal image in 13-year-old girl shows left upper lobe bronchus arising from the trachea 2 cm proximal to the carina and situs inversus totalis.
Table 1
Characteristics of Patients
VSD, ventricular septal defect; SVC, superior vena cana; LPA, left pulmonary artery; PA, pulmonary atresia; DORV, double outlet right ventricle; CoA, coarctation of aorta; AS, aortic stenosis; ASD, atrial septal defect; PDA, patent ductus arteriosus; EA, esophageal atresia; TEF, tracheoesophageal fistula; LV, left ventricle; PAPVR, partial anomalous pulmonary venous return; PS, pulmonary stenosis.
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