1699 TRACHEAL BRONCHUS: ASSOCIATION WITH RESPIRATORY MOR-bidity in childhood

Abstract

A bronchus arising from the trachea in man is an error of airway development, seen in 1-3% of adult bronchographies. At this hospital 18 cases involving the right upper lobe (RUL) were seen in 1964-79, with a frequency of 2% at bronchoscopy. One patient had a RUL mass: a tracheal bronchus leading to a sequestration was diagnosed at surgery. The other 17 were diagnosed at bronchoscopy, with bronchography in 11 cases. Ages ranged from 1 day to 54 mo (mean 17 mo). The children had respiratory complaints such as recurrent pneumonia (9 patients) or stridor (6). Eight had an ectopic RUL bronchus (“pig bronchus”), 2 an ectopic apical segmental bronchus and 5 a supernumerary bronchus (one of which was the sequestration). In 3 patients anatomic type was not defined. Ten patients had another congenital abnormality. Five of the 9 patients with recurrent pneumonia, who had either an ectopic apical or a supernumerary bronchus, underwent resection of the RUL (4) or the apical segment (1). Indication was a history of RUL disease and in 4/5 bronchographic evidence of bronchiectasis or bronchial stenosis. Through a 5 year follow up period these patients have remained well. Of the 4 unoperated patients, 2 have had additional admissions for pneumonia, involving lobes other than the RUL and therefore doubtfully related to the bronchial anomaly. In conclusion, anatomic types other than ectopic RUL bronchus were often associated with respiratory morbidity, requiring surgery in 6 out of our 10 cases.