Does the mediastinal anatomy complementing azygos lobe facilitate endotracheal balloon rupture of the trachea?

Abstract

Azygos lobe is considered to be an anatomical variant of no clinical significance; therefore it is often not reported by radiologists reading chest radiographs or computed tomographic (CT) scans.1 Surgeons and anesthesiologists have also accepted its presence without misgivings. We herein report the presence of an azygos lobe associated with intraoperative tracheal rupture. This coincidence focused our attention on the changes in mediastinal anatomy known to be part of the azygos lobe syndrome.2,3 These essentially remove all support to the membranous portion of the trachea, thus contributing to intraoperative balloon laceration.