An unusual case of congenital short trachea with very long bronchi mimicking bronchial asthma

Flow volume curve: A diagnostic tool in extrathoracic airway obstruction

The flow-volume loop (F/V-loop) is a presentation of inhalation and exhalation of air stream volume during inspiration and expiration. It demonstrates the obstructive, restrictive and mixed pattern lung pathology. Flow-volume loop has been extensively used for evaluating the severity, progression and resolution of various causes of upper-airway conditions.

Flow-volume loop abnormality detecting a previously unrecognized right upper lobe tracheal bronchus

Tracheal bronchus is a rare anatomic variant in which a bronchus originates from the trachea. Patients may be asymptomatic or present with a variety of respiratory symptoms. We present a case of a patient who presented with a history of poorly controlled asthma and a persistent abnormality of the flow-volume loop. Bronchoscopy revealed a tracheal bronchus with narrowed right-sided bronchial orifices. An unrecognized tracheal bronchus may result in serious complications during elective or emergent endotracheal intubation. Spirometry testing may reveal abnormalities of the flow-volume loop associated with altered airflow. Relying on spirometric values without assessing the shape of the flow-volume loop may lead to misdiagnosis and inappropriate management of lung pathology.

Wheeze

Wheeze is a continuous, musical, whistling-like abnormal breath sound that is usually heard in expiration. It is a common respiratory symptom and sign in children and adults; the 1958 British National Cohort study found the cumulative incidence of wheezing illness by age 33 to be 43% ( Strachan et al, 1996 ). This article considers wheeze only in adults.