Tracheal Bronchus With Difficult Lung Isolation: A Case Report

Tracheal bronchus (TB) occurs in 0.1-3% of the population as an accessory bronchus that originates in the trachea, typically supplying the right upper lobe. The presence of a TB can pose unique airway challenges, particularly during procedures that require lung isolation. Here, we describe a case of TB with difficult lung isolation. Careful examination with fiberoptic bronchoscopy permitted double lumen tube positioning without obstruction of the TB. A second case is presented where the presence of TB did not affect anesthetic management. Implications of TB for airway management and strategies for successful one-lung ventilation are discussed.