Trachealbronchus

Beyond
bronchitis: a review of the congenital and acquired abnormalities of the bronchus. Tracheal bronchus. a Illustrations of the tracheal bronchi types. b Coronal CT imaging demonstrates a supernumerary right upper lobe bronchus (solid arrow) originating from the trachea
insightsimaging.springeropen.com • Open Access
Imaging of
congenital lung diseases presenting in the adulthood: a pictorial review. CT images of tracheal bronchi in different patients. Blind-ended tracheal bronchus is seen on coronal (a, arrow) and 3D reconstruction (b, star) CT images. Tracheal bronchi with accompanying lung tissue are demonstrated on coronal (c, e, arrow) and 3D reconstruction (d, f, star) CT images in two patients. The tracheal bronchus supplies the apical and posterior segments of the right upper lobe (e, arrow) and the right middle bronchus supplies the anterior segment of the right upper lobe (f, red arrow) in a 43-year-old asymptomatic male patient
insightsimaging.springeropen.com • CC-by-4.0
One-lung
ventilation and 3D image analysis in a case of tracheal bronchus with steeply angled branching of left main bronchus: a case report. Modified schematic diagram of right TB classification (Conacher’s classification) [9]. Types I and II: the right TB is distant (> 2 cm) from the tracheal bifurcation. The distal trachea is either a narrow bronchial structure (type I) or a normal tracheal structure (type II). Type III: the right TB is close (< 2 cm) to the tracheal bifurcation and appears as a three-branching structure. TB: tracheal bronchus
jaclinicalreports.springeropen.com • CC-by-4.0
Endobronchial
angiofibroma in the aberrant tracheal bronchus presenting as spontaneous pneumomediastinum. a Initial chest X ray shows pneumomediastinum. b Bronchoscopy finding of a protruding and glistering tumour originating from the right side of the trachea. c Computed tomography showing an elongated endobronchial tumour in the accessory tracheal bronchus originating from the right side of the lower tracheal wall (black arrow, axial view). d Computed tomography showing a tumour located in the right upper lobe from the accessory tracheal bronchus (white arrow, coronal view)
cardiothoracicsurgery.biomedcentral.com • CC-by-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

A tracheal bronchus (with some variations also known as a pig bronchus) is an anatomical variant where an accessory bronchus originates directly from the supracarinal trachea. The latter term (pig bronchus or bronchus suis) is often given when the entire upper lobe (usually right side) is supplied by this bronchus .

However, this term is used in some literature to encompass a wider spectrum of abnormalities including accessory bronchi originating from either the trachea or main bronchi.

Epidemiology

Incidence is estimated at ~1% (range 0.1-2%), and there is a marked right sided predilection .

Clinical presentation

Often incidentally discovered and most patients are asymptomatic. Occasionally patients may have a recurrent (right) upper lobe pneumonia due to focal emphysematous change.

Pathology

Tracheal bronchi arise from the right lateral wall of the trachea usually at a distance of <2 cm from the level of the carina .

They can be classified into two main types:

  • supernumerary: usual bronchial supply to affected lung segment is concurrently present
  • displaced: usual bronchial supply to affected lung segment is concurrently absent

Radiographic features

CT

CT is the best modality for assessing the anatomy and allows direct visualization and orientation of the anomalous bronchus. Coronal multi-planar reconstructions in "lung window" settings are the most helpful and is best in depicting this anomaly.

History and etymology

It was initially described by Sandifort in 1785 .

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Trachealbronchus:
kongenitale
Anomalien des Tracheobronchialsystems
insightsimaging.springeropen.com • CC-by-4.0
Conacher
Klassifikation Trachealbronchus
jaclinicalreports.springeropen.com • CC-by-4.0