[Complication related to tracheal bronchus in infant: case report.]

Tracheal bronchus is a congenital abnormality affecting approximately 2% of general population, usually asymptomatic and of incidental diagnosis. It is characterized by the presence of the bronchus to the right upper lobe emerging directly from the trachea, close to the carina. Tracheal tube may obliterate its lumen, leading to right upper lobe atelectasis. This article aimed at reporting a case of right upper lobe atelectasis in infant, noticed after tracheal intubation, and also presenting a literature review on this abnormality, highlighting its anesthetic implications.

Male patient, mulatto, 5 months old, 5 kg, physical status ASA I, scheduled for anorectal fistula correction (Mini-Peña). Right subclavian vein was punctured after tracheal intubation, followed by desaturation and decreased right apex vesical murmur. Initial hypotheses were hemothorax, pneumothorax, bronchial secretion and selective intubation. Chest X-rays have shown right upper lobe atelectasis. Bronchoscopy revealed tracheal bronchus. Tube was repositioned with re-expansion of the affected lobe.

Because of its relatively high incidence (2%), tracheal bronchus should be included among right upper lobe atelectasis differential diagnoses.