Aberrant Airways: Trifurcation of the Right Main Bronchus

Abstract

Anomalies within the bronchial tree anatomy are being recognized more readily with modern imaging and investigative techniques. Bronchoscopy, selective bronchography, computed tomography with 3-dimensional reconstruction, and magnetic resonance images have broadened the potential of visualization and imaging of lung anatomy. These various reformation techniques define anatomy down to the subsegmental level and can track unusual connections. In comparison to the numerous variations of lobar and segmental bronchial subdivisions, abnormal bronchi originating from the trachea or main bronchi are infrequently reported. These relatively rare variations are described by pathologists, surgeons, and bronchoscopists. Patients who have undergone flexible bronchoscopy demonstrate up to 12% incidence of congenital tracheobronchial variant or anomaly. We report a case of a clustered bronchial take off at the level of the bronchus intermedius of the right lung. It was an incidental finding and had no immediate effect, neither detectable past effect, on the patient respiratory system. We found no current explanation theory that can account for its pattern of development.