Journal of Association of Pulmonologist of Tamil Nadu

: 2021  |  Volume : 4  |  Issue : 3  |  Page : 132--133

What is the airway abnormality?

M Vishnu Sharma, MB Sohail Mohammed, Uzair Baig 
 Department of Respiratory Medicine, A J Institute of Medical Sciences and Research Centre, Yenopoya Medical College, Mangalore, Karnataka, India

Correspondence Address:
M Vishnu Sharma
Department of Respiratory Medicine, A J Institute of Medical Sciences and Research Centre, Kuntikana, Mangalore, Karnataka

How to cite this article:
Sharma M V, Sohail Mohammed M B, Baig U. What is the airway abnormality?.J Assoc Pulmonologist Tamilnadu 2021;4:132-133

How to cite this URL:
Sharma M V, Sohail Mohammed M B, Baig U. What is the airway abnormality?. J Assoc Pulmonologist Tamilnadu [serial online] 2021 [cited 2022 Jul 3 ];4:132-133
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This is the computed tomography (CT) scan of a patient who was admitted with left-sided chest pain and cough for the past 6 weeks. What is the airway abnormality? [Figure 1], [Figure 2], [Figure 3].{Figure 1}{Figure 2}{Figure 3}


Careful comparison of the three images shows right-sided tracheal bronchus. In addition, there was a large intrathoracic mass which was confirmed as non-Hodgkin's lymphoma on biopsy.

When a bronchus originates directly from the trachea before the tracheal bifurcation, it is known as tracheal bronchus. Usually, the origin is within 2–6 cm above the carina. Tracheal bronchus is more common on the right side.[1] The prevalence is 0.1%–2% in various studies.[1],[2]

When a tracheal bronchus is associated with normal branching pattern in the upper lobe, it is called supernumerary tracheal bronchus.[1] If a tracheal bronchus is associated with missing of upper lobe bronchial division, it is known as displaced tracheal bronchus. Displaced tracheal bronchus is more common than supernumerary tracheal bronchus.[3]

Tracheal bronchus can be identified during bronchoscopy and high-resolution spiral CT scan of the chest. CT scan is superior to bronchoscopy as it can delineate the entire anatomy, relation to other intrathoracic structures and other associated anatomical abnormalities if any.[1]

Tracheal bronchus may be associated with other congenital anomalies such as hypoplastic lung, congenital heart disease, chromosomal abnormality, and spinal fusion defects.[4] Majority of tracheal bronchus are asymptomatic. It can predispose to recurrent infection, pneumonia, bronchiectasis, hemoptysis, and malignancy.[1] During intubation, misplacement of endotracheal tube to the tracheal bronchus may lead to serious hypoxia and barotrauma if not recognized and corrected promptly.[5]

Asymptomatic tracheal bronchus does not require any treatment. In symptomatic patients, treatment should be directed to the underlying condition. Surgical resection may be required when conservative treatment fails.[6]

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Conflicts of interest

There are no conflicts of interest.


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