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Tracheal bronchus: a cause of prolonged atelectasis in intubated children
B P O'Sullivan1, J J Frassica, S M Rayder
1Department of Pediatrics, University of Massachusetts Medical Center, Worcester, USA.
Insights
A tracheal bronchus, an airway anomaly in 2% of people, can cause persistent right upper lobe atelectasis in intubated children. Early identification is key for appropriate airway management and preventing complications.
Area of Science:
- Anatomy
- Pediatric Medicine
- Pulmonology
Background:
- Tracheal bronchus is a congenital anomaly affecting approximately 2% of the population.
- This anomaly can lead to localized pulmonary complications, particularly in pediatric patients requiring endotracheal intubation.
Observation:
- Two cases are presented involving children with complex medical histories necessitating endotracheal intubation.
- Both patients experienced persistent right upper lobe atelectasis during their hospital stay.
Findings:
- The presence of a tracheal bronchus was initially unrecognized in both pediatric cases.
- Identifying this anatomical variant was crucial for modifying airway management strategies.
Implications:
- Tracheal bronchus should be considered in the differential diagnosis of intubated patients presenting with right upper lobe atelectasis.
- Early recognition and appropriate airway management are essential for optimizing outcomes in patients with this anomaly.
Abstract:
Tracheal bronchus is a common anomaly that occurs in approximately 2% of people. Two children with multiple medical problems which led to endotracheal intubation are described. The hospital course for each child was complicated by persistent right upper lobe atelectasis. The presence of a tracheal bronchus was not recognized in either case initially; identification of this anatomic variant allowed appropriate changes in airway management. The potential for tracheal bronchus to cause, or be associated with, localized pulmonary problems is reviewed. The diagnosis of tracheal bronchus should be considered early in the course of intubated patients with right upper lobe complications.