Congenital tracheal stenosis and an anomalous origin of the right upper lobe bronchus

Abstract

In October, 2006, a 29-year-old woman visited our hospital because of severe dyspnoea. She had a history of recurrent respiratory infections. On admission, mild wheezing was noted at rest, and on exercise she developed a noticeable stridor. Serum C-reactive protein was slightly increased. Initially, she was treated for asthma with oxygen and nebulised salbutamol and dexamethasone. A highresolution CT scan of the chest the following day showed striking narrowing of the entire trachea with a 7 mm anteroposterior diameter. A three-dimensional image reconstructed from the CT scan showed generalised hypoplasia of the trachea and an anomalous origin of the right upper lobe bronchus with a narrow opening (fi gure). Final diagnosis was congenital tracheal stenosis with viral respiratory infection. She was successfully treated and was discharged in November, 2006. Although very rare, congenital tracheal stenosis should be considered as a diff erential diagnosis of intractable adult asthma. Lancet 2008; 371: 1526