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Clinical and computed tomographic features of tracheal bronchus in children
1Division of Pediatric Pulmonology, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Insights
Tracheal bronchus, a rare congenital anomaly, was found in 2.4% of pediatric bronchoscopies. Symptoms in children with tracheal bronchus were often unrelated to the anomaly itself.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Congenital Airway Anomalies
Background:
- Tracheal bronchus is a congenital malformation of the airway.
- Its prevalence and clinical significance in pediatric populations require further elucidation.
Purpose of the Study:
- To determine the incidence of tracheal bronchus in children undergoing bronchoscopy.
- To analyze the clinical presentation and associated conditions in pediatric patients with tracheal bronchus.
Main Methods:
- Retrospective review of pediatric bronchoscopic studies conducted between July 1994 and June 1998.
- Analysis of patient records to identify cases of tracheal bronchus and associated respiratory symptoms or abnormalities.
Main Results:
- Eleven cases (2.4%) of tracheal bronchus were identified in 462 children (492 studies).
- The majority of patients (10/11) with tracheal bronchus did not present with symptoms directly attributable to this anomaly.
- Six patients (54.5%) had coexisting tracheobronchial stenosis; one patient also had a high carina bifurcation.
Conclusions:
- Tracheal bronchus is an uncommon finding in pediatric bronchoscopies.
- Clinical symptoms in children with tracheal bronchus are frequently due to other underlying conditions, such as tracheobronchial stenosis.
- Conservative management is often appropriate for tracheal bronchus, with a focus on addressing any coexisting abnormalities.
Abstract:
We retrospectively reviewed the records of all children who received bronchoscopic studies in our hospital from July 1994 through June 1998, to identify cases of tracheal bronchus. During the 4-year period, 462 children underwent a total of 492 bronchoscopic studies. Eleven (2.4%) of these children (9 boys, 2 girls, aged 1 mo to 11 yrs) had tracheal bronchus. Most of these patients underwent bronchoscopy because of respiratory difficulties, but the symptoms were not attributable to tracheal bronchus in 10 of the 11 children. Six out of the 11 patients had coexisting tracheobronchial stenosis. Bronchoscopy indicated high bifurcation of the carina in one patient, and direct coronal computed tomography demonstrated concomitant tracheal stenosis and tracheal bronchus. Most patients with tracheal bronchus can be treated conservatively. Correction of the underlying abnormalities is of paramount importance for the relief of respiratory symptoms.