The utility of CT virtual bronchoscopy in the esophageal lung diagnosis: A case report

Abstract

The esophageal lung is a variant of the communicating bronchopulmonary foregut malformation (CBPFM). It needs a high index of suspicion for diagnosis because it is a rare condition and does not have specific symptoms. A CT scan or an esophageal contrast study, showing direct communication between the airways and the esophagus or stomach, confirms the diagnosis. Patients with esophageal lung need flexible bronchoscopy for evaluating tracheobronchial anomalies. We present a three-month-old boy with a right esophageal lung in which the CT virtual bronchoscopy showed an absence of the right main bronchus at the carina level. This case report highlights the importance of CT virtual bronchoscopy as an alternative to flexible bronchoscopy for the diagnosis of tracheobronchial anomalies associated with CBPFM.

Keywords: CBPFM; Communicating bronchopulmonary foregut malformation; Esophageal lung; Tracheoesophageal fistula; Virtual bronchoscopy.

Fig. 1

Chest X-ray shows a total collapse of the right lung with mediastinal shift. Note the convergence and downward orientation of the right lung airway toward the lower esophagus.

Fig. 2

The chest CT scan shows total collapse of the right lung with marked hypoplasia of the right pulmonary artery (red arrow). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

Fig. 3

An upper GI study shows abnormal direct communication between the right main bronchus and esophagus at its lower part with focal stenosis at the site of communication (arrow).

Fig. 4

CT Virtual bronchoscopy (A) with 3D reconstruction of the airway (B). Note the blind end of the right main bronchus with normal left main airway structures.