Presence of tracheal bronchus in children undergoing flexible bronchoscopy.
OBJECTIVE
Tracheal bronchus (TB) is a rare congenital malformation of the lung tree with a bronchus originating from the trachea. Only a small number of publications have analyzed the frequency and diagnostic procedure of TB in children, based on a restricted sample of patients. In the present study, we analyze and discuss new aspects of prevalence, clinical presentation and associated malformations of TB based on a large pediatric cohort.


METHODS
Data from 5970 children having a flexible bronchoscopy for investigation of respiratory symptoms were selected. We analyzed the anaesthesic management, the presence of associated malformations, and all tracheobronchial anomalies observed during the endoscopic procedure.


RESULTS
Fifty-seven cases of tracheal bronchus were identified (0.9%). In the majority of them, tracheal bronchus was a fortuitous discovery without clear clinical relevance. Statistical analysis revealed that the majority of TB originated from the middle and lower one third of the trachea (56%). 61.5% of patients had associated anomalies such as syndromic association (21%), cardiac malformations (19.2%) or tracheal stenosis (14%). Only 38.5% of children had no associated anomalies.


CONCLUSIONS
Tracheal bronchus is a rare morphological anomaly of the tracheobronchial tree. Most often TB is associated with other birth defects such as another tracheo-bronchial tree malformation, vascular abnormality, congenital heart malformation or in the context of a syndromic pattern. A relationship between respiratory symptoms and the presence of TB is very rare and selective treatment is infrequent.
Unité de Pneumologie Pédiatrique, Département de Pédiatrie, Hôpitaux Universitaires de Genève, Geneva, Switzerland; Département de Pathologie et Immunologie, Faculté de Médecine, Université de Genève, Geneva, Switzerland. Electronic address: isabelle.ruchonnet-metrailler@hcuge.ch.
Isabelle
I
Ruchonnet-Metrailler
Service de Pneumologie et Allergologie, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.
Rola
R
Abou Taam
Service de Pneumologie et Allergologie, AP-HP, Hôpital Necker-Enfants Malades, Paris, France; Université Paris Descartes-Paris 5, Paris, France.
Jacques
J
de Blic
D000293:Adolescent; D001980:Bronchi / Q000002:abnormalities*; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012140:Respiratory Tract Diseases / Q000151:congenital / Q000175:diagnosis*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D014132:Trachea / Q000002:abnormalities*
Flexible bronchoscopy; Lung development; Tracheal bronchus