Bronchovascular anomalies of the right upper lobe

Bronchial anomaly of the right upper lobe

This case report presents a rare anomaly of right upper lobe bronchial anatomy. During routine right upper lobe resection for carcinoma, a common right upper and middle lobe bronchus was found. The resection was completed as a right upper and middle bilobectomy. Knowledge of this uncommon variant was beneficial in performing the pulmonary resection. A review of the literature is presented.

Tracheal bronchus: association with respiratory morbidity in childhood

An aberrant right upper lobe (RUL) bronchus arising from the trachea (tracheal bronchus) can be responsible for recurrent pneumonia. In this hospital, 2% of children requiring bronchoscopy for respiratory symptoms are found to have a tracheal bronchus, which is frequently thought to be an incidental finding. We reviewed findings in 18 patients to determine when a tracheal bronchus is of clinical significance. The age at presentation ranged from 1 day to 54 months (mean 17 months). The children had recurrent pneumonia (nine), stridor (six), respiratory distress (two) and a thoracic mass (one). Other congenital abnormalities were present in 14, including Down syndrome (two), tracheoesophageal fistula (two), and fused or hypoplastic first and second ribs (four). Recurrent RUL pneumonia was present in five. Bronchiectasis or bronchial stenosis was shown by bronchography in four of five; in all five the right upper lobe was surgically resected, with resolution of the recurrent pneumonias. The presence of a clinically significant tracheal bronchus should be considered in every child with recurrent RUL pneumonia, especially in children with Down syndrome or rib abnormalities; if bronchiectasis or bronchial stenosis is found, surgical resection should be performed.

Computed tomographic demonstration of displaced right upper lobe bronchus in an adult woman with congenital heart disease

To our knowledge, this is the first description of the computed tomographic appearance of a displaced right upper lobe bronchus. The case reported is that of a 43 year-old woman who had known congenital heart disease and systemic hypertension. The computed tomographic study demonstrated a displaced right upper lobe bronchus; a persistent left superior vena cava; pulmonary hypertension with associated dilatation of the right chambers of the heart consistent with a longstanding left to right shunt; and subsequent development of pulmonary hypertension.

Anomalous origin of the anterior segmental bronchus of the right upper lobe

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