Foreign Body Aspiration in a Child With a Rare Tracheal Bronchus

Abstract

A tracheal bronchus is an unusual bronchial division anomaly in which an accessory bronchus arises from the trachea or main bronchus and travels to the higher lobe territory. This report discusses a case of incidentally diagnosed tracheal bronchus after foreign body removal via bronchoscopy. A one-year-old boy presented to the hospital with cough and noisy breathing after choking on peanuts. On examination, he had mild tachypnea with non-prominent subcostal retractions and diminished airflow in the left lung. Rigid bronchoscopy revealed a foreign body in the trachea at the level of the left main bronchus, which was completely removed in one piece under vision using fiberoptic forceps. A tracheal bronchus is an unusual congenital abnormality, with most cases being asymptomatic. Appropriate reporting of such anomalies may help healthcare practitioners promptly diagnose, manage, and avoid complications in the tracheal bronchus.

Keywords: airway management; bronchoscopy; foreign body aspiration; trachea; tracheal bronchus.

Figure 1. Pre-operative plain chest x-ray showed left lung hyperinflation.

Figure 2. Intraoperative photography after removal of foreign body, re-examination revealed a clear airway with confirmed right tracheal bronchus (A - Left main bronchial orifice, B - Right main bronchial orifice, C - Right tracheal bronchus).