Braided bronchus: A previously undescribed airway anomaly

A 30-year-old female presenting with fever, cough and purulent sputum, and suffering from recurrent pulmonary tuberculosis

“…Bridging bronchus is usually detected during the neonatal period and is indicated by recurring atelectasis, pneumonia, bronchiectasis, chronic ventilation-perfusion mismatch, pulmonary oedema and respiratory failure [2][3][4][5][6][7][8][9]. These problems are usually caused by chronically inadequate pulmonary drainage and ventilation problems.…”

“…These problems are usually caused by chronically inadequate pulmonary drainage and ventilation problems. Bridging bronchus is also often associated with a sling pulmonary artery and, occasionally, with congenital heart disease [2,5,6,8,[10][11][12].…”

“…There has been one report describing a braided bronchus, in which the trachea and left bronchial tree were structurally normal and the right mainstem bronchus branched directly into four distinct segments [5].…”

“…Bronchography is usually required for detecting bronchial anatomical variations of bridging bronchus, in addition to computed tomography and bronchoscopy [5,6,13]. However, with the introduction of MDCT, which can provide threedimensional images, information about anatomical variations of the bronchial tree were obtained without the need for bronchography.…”

Lungs

“…Other associated anomalies, such as cardiovascular, skeletal, genitourinary, and abdominal malformations which occur in the VATER association, have been reported (Starshak et al 1981;MedinaEscobedo and Lopez-Corella 1992;Baden et al 2008). Wheeler et al (1998) reported a female infant case of braided bronchus, the only known case to have been reported (to the best of the author's knowledge). In that case, the trachea and left main bronchus were normal; however, the right main bronchus branched into four bronchi.…”