title: Computed tomography and upper gastrointestinal series findings of esophageal bronchi in infants.
abstract: BACKGROUND
  Esophageal bronchus is a rare form of communicating bronchopulmonary foregut malformation and a rare but important cause of an opaque hemithorax on chest radiography. A higher incidence of esophageal bronchus is associated with esophageal atresia, tracheo-esophageal fistula (TEF) and VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) association. In the presence of these conditions, the pediatric radiologist may be the first to consider the diagnosis of esophageal bronchus or esophageal lung.
  
  
  OBJECTIVE
  To describe the imaging features in five children with esophageal bronchus.
  
  
  METHODS
  We reviewed hospital records and teaching files at two large pediatric tertiary referral centers over the 24-year period from January 1992 to January 2016. We reviewed all imaging studies and tabulated findings on radiography, fluoroscopic upper gastrointestinal (GI) series and CT. We then described the imaging features of esophageal bronchi with emphasis on CT and upper GI findings in four infants and one toddler.
  
  
  RESULTS
  Three cases were identified from one institution (cases 2, 3, 4) and two from another (cases 1, 5). All five cases occurred in association with other midline malformations: four of the five had VACTERL association and three of the five had esophageal atresia and TEF.
  
  
  CONCLUSIONS
  Lung opacification, ipsilateral mediastinal shift, and an abnormal carina and anomalous vascular anatomy suggest an esophageal bronchus or an esophageal lung on CT. While esophageal bronchus is a rare cause of an opaque hemithorax, CT and upper GI imaging play key roles in its diagnosis. Associations with esophageal atresia with tracheo-esophageal fistula and VACTERL association are particularly pertinent. Early diagnosis of esophageal bronchus might prevent complications such as aspiration and infection, which can allow for parenchymal sparing surgery as opposed to pneumonectomy.
authors: Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA, 02115, USA. gabrielle.colleran@childrens.harvard.edu.|Department of Radiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland. gabrielle.colleran@childrens.harvard.edu.
authors: Gabrielle C
authors: GC
authors: Colleran
authors: Department of Pathology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
authors: Ciara E
authors: CE
authors: Ryan
authors: Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA, 02115, USA.
authors: Edward Y
authors: EY
authors: Lee
authors: Department of Surgery, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
authors: Brian
authors: B
authors: Sweeney
authors: Department of Radiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
authors: David
authors: D
authors: Rea
authors: Department of Radiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
authors: Clare
authors: C
authors: Brenner
mesh_terms: D001003:Anal Canal / Q000002:abnormalities / Q000000981:diagnostic imaging; D001980:Bronchi / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D004933:Esophageal Atresia / Q000000981:diagnostic imaging; D004947:Esophagus / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D005260:Female; D005471:Fluoroscopy; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D017880:Limb Deformities, Congenital / Q000000981:diagnostic imaging; D008297:Male; D012189:Retrospective Studies; D013131:Spine / Q000002:abnormalities / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014132:Trachea / Q000002:abnormalities / Q000000981:diagnostic imaging; D014138:Tracheoesophageal Fistula / Q000000981:diagnostic imaging
keywords: Computed tomography; Esophageal bronchus; Esophagus; Infant; Lung; Tracheo-esophageal fistula; Upper gastrointestinal series