The Prevalence of Tracheal Bronchus in Pediatric Patients Undergoing Rigid Bronchoscopy

Abstract

TB is a relatively common congenital endoscopic lower airway anomaly in childhood, which is itself rarely symptomatic, but almost always coexists with other congenital anomalies.

Presence of tracheal bronchus in children undergoing flexible bronchoscopy

“…In our study, a prevalence of type I TB could be observed which is known to create higher frequently anesthetic problems due to cannulation trouble during intubation, impeding correct lung ventilation, unlike observations of patients suffering from tracheal bronchus type 2 or type 3 [2,10]. Despite this higher incidence of type 1 TB in our cohort, no anesthesic problems due to tracheal intubation were described.…”

“…2). TB was also commonly observed in children with congenital heart disease (19.2%) as described by others [10,17,18].…”

“…We found a 0.9% incidence of tracheal bronchus, which is in the range of published articles (between 0.1% and 2% [2,9e13]) and almost identical as in Dave's study. However, this cohort was different to our, because rigid bronchoscopy was performed during general anesthesia for routine elective surgery and not for respiratory symptoms [10]. In our series, TB was diagnosed accidentally from patients which had flexible bronchoscopy for respiratory symptoms indications such as recurrent bronchopulmonary infections, persistent wheezing and difficult to treat asthma [14].…”

Lower airway dimensions in pediatric patients—A computed tomography study

“…Right bronchial lengths correlated considerably less with age or height compared to those on the left side. This is not surprising, as the offshoot of the upper right bronchus is very variable and results in about 1% of the normal population in a tracheal bronchus (pig lobe), whereas on the left side, the offshoot of the left upper lobe bronchus is relatively consistent. So far there are no data available that systematically compares bronchial lengths with age, height, or weight.…”

The bridging bronchus: A comprehensive review of a rare, potentially life‐threatening congenital airway anomaly associated with cardiovascular defects

“…Recognition of a BB by various imaging modalities such as MDCT can be delayed by misinterpretation of the pseudocarina as the normal tracheal bifurcation, the RMB being identified as the tracheal bronchus (TB) (an aberrant bronchus arising from the trachea) . The TB is a congenital anomaly in which an RUL bronchus has its origin in the trachea rather than at the carina . It can complicate endotracheal intubation, because its cannulation can obstruct the ventilation of the rest of the lung and increase the risk of pneumothorax.…”