Esophageal bronchus

Preschooler
with chronic cough. CXR AP (left) shows near complete opacification of the left hemithorax with mediastinal shift to the left. AP image from an esophagram (right) shows a fistulous connection from the esophagus to the left mainstem bronchus.The diagnosis was esophageal bronchus.
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Esophageal bronchus, a.k.a. communicating bronchopulmonary foregut malformation, refers to the rare occurrence where a bronchus arises directly from the esophagus.

Epidemiology

It is more common in females with a M:F of 1:2 .

Gross anatomy

Esophageal bronchi may be the main bronchus, which gives rise to esophageal lung, or may be a lobar bronchus, most commonly a lower lobe bronchus.

Associations

Blood supply

Arterial supply and venous drainage are variable:

  • arterial supply: may arise directly from the thoracic aorta
  • venous drainage: may be to systemic or pulmonary circulations

Radiographic appearance

Plain radiograph
  • unilateral alveolar opacity and air bronchogram as a result of aspiration
  • mediastinal shift to the affected side
Fluoroscopy
  • barium fills the bronchus and first-order branches