Acute respiratory failure secondary to bronchogenic cyst in an adult

Bronchogenic cysts are a rare congenital malformation most commonly seen in children. The ones that do not present acutely in childhood often evade diagnosis until adulthood due to their asymptomatic indolent course. When symptomatic, they present with non-specific manifestations such as wheezing, cough, and breathlessness on exertion. Acute respiratory distress is a rare presentation in adulthood. In our case, a 41-year-old male patient presented with hypoxemic respiratory failure leading to cardiac arrest, warranting cardiopulmonary resuscitation and mechanical ventilation. A large bronchogenic cyst was found to be causing critical tracheal stenosis and splaying the great vessels and branches. Cyst was excised and marsupialized in toto through a trans-sternal approach, and the patient was discharged on post-operative day 6.