Abstract
Trakeal bronkus, trakeadan kaynaklanan sağ bronchus lobaris superior olup, ilk olarak 1785’te tanımlanmıştır. Genelde karinanın sağ üst tarafında, sağ akciğerin üst lobunun segmentum apicale’sini havalandıran nadir görülen konjenital bir anomalidir ve üç tipi vardır. Bir yıldır öksürük ve nefes darlığı şikayeti olan 41 yaşındaki erkek hastanın çekilen kontrastlı aksiyal ve koronal reformat toraks bilgisayarlı tomografisinin incelenmesi sonucunda sağ akciğerindeki bronchus lobaris superior’unun karina üstünden ayrıldığı görülmüştür. Tekrarlayan akciğer enfeksiyonu olan hastalarda ve özellikle Down sendromu olmak üzere konjenital kalp hastalıkları, aspleni sendromu ve kosta anomalileri gibi ek anomalisi olan vakalarda olası trakeobronşial anomaliler akılda tutulmalıdır. Bu hastalara uygulanan yanlış endotrakeal entübasyonun, atelektazi ve pnömotoraks gibi komplikasyonlara neden olabileceği düşünülmelidir. Bunun yanı sıra anestezi öncesi bilgisayarlı tomografi ile anatomik yapının değerlendirilmesi varyasyonların tanımlanması açısından önemlidir
Keywords
References
- Kubik S, Muntener M. Bronchus abnormalities: tracheal, eparterial, and pre-eparterial bronchi. Fortschr Geb Ront- genstr Nukl 1971;114:145-63.
- Ulusoy M, Uysal II, Kivrak AS, et al. Age and gender related changes in bronchial tree: a morphometric study with multi dedector CT. Eur Rev Med Pharmacol Sci 2016;20:3351-7.
- Ghaye B, Szapiro D, Fanchamps JM, et al. Congenital bron- chial abnormalities revisited. Radiographics 2001;21:105– 19.
- Wooten C, Patel S, Cassidy L, et al. Variations of the tracheo bronchial tree: anatomical and clinical significance. Clin Anat 2014;27:1223-33.
- Ruchonnet-Metrailler I, Abou Taam R, de Blic J. Presence of tracheal bronchus in children under going flexible bron- choscopy. Respir Med 2015;109:846-50.
- Conacher ID. Implications of a tracheal bronchufor adult anaesthetic practice. Br J Anaesth 2000;85:317-20.
- Boyden EA. Developmental anomalies of the lungs. Am J Surg 1955;89:79-89.
- Zylak CJ, Eyler WR, Spizarny DJ, Stone CH. Developmental lung anomalies in the adult: radiologic-pathologic correla- tion. Radiographics 2002;22:25-43
- Doolittle AM, Mair EA. Tracheal bronchus: Classification, endoscopic analysis and airway management. Otolaryngol- Head Neck Surg 2002;126:240–3.
- Lee DK, Kim YM, Kim HZ, Lim SH. Right upperlobe tra- cheal bronchus: anesthetic challenge in one-lung ventila- ted patients—are port of three cases. Korean J Anesthesiol 2013;64:448–50.
- Evans JA. Aberrant bronchi and cardiovascular anomalies. Am J Med Genet 1990;35:46–54.
- Ming Z, Lin Z. Evaluation of tracheal bronchus in Chi- nese children using multidetector CT. Pediatr Radiol 2007;37:1230-4.
- McLaughlin FJ, Strieder DJ, Harris GB, Vawter GP, Eraklis AJ. Tracheal bronchus: association with respiratory morbi- dity in childhood. J Pediatr 1985;106:751–5.
- Lai KM,Hsieh MH, Lam F, et al. Anesthesia for patients with tracheal bronchus. Asian J Anesth 2017;55:87-8.
- Gönlügür U, Akkurt İ, Özşahin SL. Ektopik bronşlar. Akci- ğer Arşivi 2002;3:86-8.
- Remy J, Remy -Jardin M, Artaud D, Fribourg M. Multip- lanar and three-dimensional reconstruction techniques in CT: impact on chest diseases. Eur Radiol 1998;8:335-51.
- Kelekçi S, Meteroğlu F, Şen V,ve ark. Nadir görülen bir trakeo bronşial anomali ‘trakeal bronkus’. Respir Case Rep 2013;2:57-9.
- Adalı F. Klinik olarak bronkoskopi endikasyonu olan has- talarda sanal bronkoskopi ile fiber optik bronkoskopinin karşılaştırılması. Uzmanlık Tezi. Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Radyodiagnostik Kliniği, İstanbul, 2007.
- Dave MH, GerberABailey M,et al. The prevalence of trac- heal bronchus in pediatric patients under going rigid bron- choscopy. Journal of Bronchology Interventional Pulmono- logy2014;21:26-31.
Abstract
Tracheal bronchus is a right superior lobar bronchus originating from trachea, first described in 1785. In general, on the right side of the supracarina, a rare congenital anomaly that ventilates the apical segment of superior lobe of the right lung, and there are three types. Contrast-enhanced axial and coronal reformat thoracic computed tomography of a 41-year-old male patient with complaints of cough and shortness of breath for one year showed that right superior lobar bronchus of right long separated from supracarina of trachea. Possible tracheobronchial anomalies should be kept in mind in patients with recurrent pulmonary infections, especially in cases of Down syndrome, congenital heart diseases, asplenia syndrome, and costa anomalies. It should be considered that wrong endotracheal intubation applied to this patients may cause complications such as atelectasis and pneumothorax. In addition, evaluation of the anatomical structure by computerized tomography prior to anesthesia is important in defining the variations
Keywords
References
- Kubik S, Muntener M. Bronchus abnormalities: tracheal, eparterial, and pre-eparterial bronchi. Fortschr Geb Ront- genstr Nukl 1971;114:145-63.
- Ulusoy M, Uysal II, Kivrak AS, et al. Age and gender related changes in bronchial tree: a morphometric study with multi dedector CT. Eur Rev Med Pharmacol Sci 2016;20:3351-7.
- Ghaye B, Szapiro D, Fanchamps JM, et al. Congenital bron- chial abnormalities revisited. Radiographics 2001;21:105– 19.
- Wooten C, Patel S, Cassidy L, et al. Variations of the tracheo bronchial tree: anatomical and clinical significance. Clin Anat 2014;27:1223-33.
- Ruchonnet-Metrailler I, Abou Taam R, de Blic J. Presence of tracheal bronchus in children under going flexible bron- choscopy. Respir Med 2015;109:846-50.
- Conacher ID. Implications of a tracheal bronchufor adult anaesthetic practice. Br J Anaesth 2000;85:317-20.
- Boyden EA. Developmental anomalies of the lungs. Am J Surg 1955;89:79-89.
- Zylak CJ, Eyler WR, Spizarny DJ, Stone CH. Developmental lung anomalies in the adult: radiologic-pathologic correla- tion. Radiographics 2002;22:25-43
- Doolittle AM, Mair EA. Tracheal bronchus: Classification, endoscopic analysis and airway management. Otolaryngol- Head Neck Surg 2002;126:240–3.
- Lee DK, Kim YM, Kim HZ, Lim SH. Right upperlobe tra- cheal bronchus: anesthetic challenge in one-lung ventila- ted patients—are port of three cases. Korean J Anesthesiol 2013;64:448–50.
- Evans JA. Aberrant bronchi and cardiovascular anomalies. Am J Med Genet 1990;35:46–54.
- Ming Z, Lin Z. Evaluation of tracheal bronchus in Chi- nese children using multidetector CT. Pediatr Radiol 2007;37:1230-4.
- McLaughlin FJ, Strieder DJ, Harris GB, Vawter GP, Eraklis AJ. Tracheal bronchus: association with respiratory morbi- dity in childhood. J Pediatr 1985;106:751–5.
- Lai KM,Hsieh MH, Lam F, et al. Anesthesia for patients with tracheal bronchus. Asian J Anesth 2017;55:87-8.
- Gönlügür U, Akkurt İ, Özşahin SL. Ektopik bronşlar. Akci- ğer Arşivi 2002;3:86-8.
- Remy J, Remy -Jardin M, Artaud D, Fribourg M. Multip- lanar and three-dimensional reconstruction techniques in CT: impact on chest diseases. Eur Radiol 1998;8:335-51.
- Kelekçi S, Meteroğlu F, Şen V,ve ark. Nadir görülen bir trakeo bronşial anomali ‘trakeal bronkus’. Respir Case Rep 2013;2:57-9.
- Adalı F. Klinik olarak bronkoskopi endikasyonu olan has- talarda sanal bronkoskopi ile fiber optik bronkoskopinin karşılaştırılması. Uzmanlık Tezi. Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Radyodiagnostik Kliniği, İstanbul, 2007.
- Dave MH, GerberABailey M,et al. The prevalence of trac- heal bronchus in pediatric patients under going rigid bron- choscopy. Journal of Bronchology Interventional Pulmono- logy2014;21:26-31.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | March 1, 2019 |
| Published in Issue | Year 2019 Volume: 29 Issue: 2 |
Journal of General Medicine is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).