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Tracheal Bronchus; A Computed Tomography Study

Year 2020, Volume: 10 Issue: 1, 40 - 44, 31.03.2020
https://doi.org/10.16899/jcm.619857

Abstract

Aims:  The aim of the study recognize and classify
the Tracheal Bronchus (TB) in our population.

Materials and
Methods:
A total
of 1500 patients who underwent thoracic Computed Tomography (CT) examination
for different reasons were enrolled in this retrospective study. 12 patients
with TB were reported. Of the 12 patients with TB; five were males and seven
were females. Prevalence of TB was found to be 0.8%. It was indicated more
frequently in women (58.3%) than in men (41.7%).

Results: Of the 12 patients with TB seven
had displaced type (58.3%), two had supernumerary type (16.7%) and three had
pig bronchus (25%). Displaced type was most common among the females. Of the five
males two had displaced type, two had pig bronchus and one had supernumerary
type. Relation between gender and type was not found to be statistically
significant (p=0.516). The mean diameter of the TB was 5.24±1.53 mm. Difference
between displaced and pig bronchus types according to diameter is statistically
significant (p=0.017). Distance between carina and TB was also measured in the
present study. There was no difference between displaced type and pig bronchus
type according to distance from carina (p=0.067).


























Conclusions: Recognizing the TB is critically
important during endotracheal intubation. When the TB is occluded by the side
of the tube the lobe may collapse. On the other hand when it is mistakenly
intubated, over aeration may lead pneumothorax.

Supporting Institution

No financial support

References

  • Referans1. Doolıttle AM, Maır EA Tracheal bronchus: classification, endoscopic analysis, and airway management Otolaryngol Head Neck Surg2002;126:240-3. doi:10.1067/mhn.2002.122703.
  • Referans2. Levin E, Bowling MR. Malignancy in the tracheal bronchus: A case series and review of the literature. Clin Respir J. 2018; 12:2441–2445. doi: 10.1111/crj.12943.
  • Referans3. Manjunatha YC, Gupta AK. Tracheal Bronchus (Pig Bronchus). Indian J Pediatr 2010; 77:1037–1038. doi: 10.1007/s12098-010-0162-6.
  • Referans4. Han J, Xiang H, Ridley WE, Ridley LJ. Pig bronchus. 2018 The Royal Australian and New Zealand College of Radiologists. doi:10.1111/1754-9485.21_12785.
  • Referans5. Qi S, Zhang B, Yue Y, Shen J, Teng Y, Qian W, Wu J. Airflow in Tracheobronchial Tree of Subjects with Tracheal Bronchus Simulated Using CT Image Based Models and CFD Method. Med Syst. 2018; Mar 1;42(4):65. doi: 10.1007/s10916-017-0879-0.
  • Referans6. Lee DK, Kim YM, Kim HZ, Lim SH. Right upper lobe tracheal bronchus: anesthetic challenge in one-lung ventilated patients -A report of three cases- Korean J Anesthesiol 2013 May 64(5): 448-450.
  • Referans7. Barbetta C,Tamburini N, Marchi I, Forini G, Papi A. True tracheal bronchus. Anaesthesia 2016, 71, 846. doi:10.1111/anae.13531.
  • Referans8. Sindhwani G, Rawat J, Gupta M, Chandra S. Lung Cancer in “True Tracheal Bronchus” A Rare Coincidence. J Bronchol Intervent Pulmonol 2012;19:340–342.
  • Referans9. Ruiz EP, Aguilera PC, Valdivielso AI, Cárdenas SS, García YM, Frías JP. Tracheal bronchus diagnosed in children undergoing flexible bronchoscopy. Paediatric Respiratory Reviews 28 (2018) 26–30.
  • Referans10. Jain D, Bhardwaj N, Pareek A, Parikh B. Tracheal bronchus: an unusual cause of difficult ventilation. Can J Anesth/J Can Anesth (2017) 64:979–980 DOI 10.1007/s12630-017-0919-8.
  • Referans11. Wong F, Detterbeck F, Kurup V. Airway Management in Patients with Tracheal Bronchus. Images in Anesthesiology. Anesthesiology, 2016,125(2), 395. doi:10.1097/aln.0000000000001019.
  • Referans12. Schoenwolf GC, Blely SB, Brauer PR, Francis-West PH. Larsen’s Human Embryology, 5th Edt.(2015),Elsevier, 252-259.
  • Referans13. Moore KL, Persaud TVN, Torchia MG. The Developing Human-Clinically Oriented Embryology, 10th Edt.(2016), Elsevier, 195-200.
  • Referans14. Carlson BM, Human Embryology and Developmental Biology, 5th Edt.(2014), Elsevier, 359-362.
  • Referans15. Snowball J, Ambalavanan M, Whitsett J, Sinner D. Endodermal Wnt signaling is required for tracheal cartilage formation. Dev.Biol. 2015 Sep 1;405(1):56-70. doi: 10.1016/j.ydbio.2015.06.009.
  • Referans16. Mendognia P, Tosia D, Rossoa L, Palleschia A, Righia I, Montolia M, Marioloa AV, Nosottia M. Lung Transplant From Donor With Tracheal Bronchus: Case Report and Literature Review. Transplantation Proceedings, 51, 239e241 (2019).
  • Referans17. Ho AK, Ho AMH, Mizubuti GB. Blockage of the tracheal bronchus: effects on blood oxygen content, partial pressure of oxygen, and intrapulmonary shunt. Adv Physiol Educ 42: 383–386, 2018; doi:10.1152/advan.00017.2018.
  • Referans18. Lai KM, Hsieh MH, Lama F, Chen CY, Chen TL, Chang CC. Anesthesia for patients with tracheal bronchus. Asian Journal of Anesthesiology 55 (2017) 87-88.

Trakeal Bronkus; Bilgisayarlı Tomografi Çalışması

Year 2020, Volume: 10 Issue: 1, 40 - 44, 31.03.2020
https://doi.org/10.16899/jcm.619857

Abstract

Amaç: Bu çalışmanın amacı, popülasyonumuzdaki
Trakeal Bronkusları (TB) tespit etmek ve sınıflandırmaktır.

Gereç ve
Yöntem:
Bu
retrospektif çalışmaya farklı nedenlerle torasik BT çektiren toplam 1500 hasta
dahil edildi. 12 bireyde TB tespit edildi.
TB'li 12 hastanın; beşi erkek, yedisi kadındı. TB
prevalansı     %0,8 bulundu. Kadınlarda
(% 58,3) erkeklerden (% 41,7) daha sık tespit edildi.

Bulgular: TB’lu 12 bireyin yedisinde displaced
tip (% 58.3), ikisinde supernumarary tip (% 16.7) ve üçünde pig tip (% 25) bronkus
vardı. Displaced tip kadınlar arasında en yaygın olanıdıydı. Beş erkekten
ikisinde displaced tip, ikisinde pig tip, birinde supernumerary tip görüldü.
Cinsiyet ve tip arasındaki ilişki istatistiksel olarak anlamlı bulunmadı (p =
0.516). TB'nin ortalama çapı 5.24 ± 1.53 mm idi. Displaced ve pig bronkus
tipleri arasındaki çapa göre fark istatistiksel olarak anlamlıydı (p = 0,017).
Bu çalışmada ayrıca carina ve TB arasındaki mesafe de ölçüldü. Displaced tip
ile pig bronkus tiplerinin carina’ya olan mesafeleri açısından fark yoktu (p =
0.067).


























Sonuç: TB'nin tanınması endotrakeal
entübasyonda kritik öneme sahiptir. TB, tüpün yan yüzü tarafından tıkandığında,
lob kollapsa uğrayabilir. Diğer yandan, yanlışlıkla entübe edildiğinde, aşırı
havalanma sonucu pnömotoraks oluşabilir.

References

  • Referans1. Doolıttle AM, Maır EA Tracheal bronchus: classification, endoscopic analysis, and airway management Otolaryngol Head Neck Surg2002;126:240-3. doi:10.1067/mhn.2002.122703.
  • Referans2. Levin E, Bowling MR. Malignancy in the tracheal bronchus: A case series and review of the literature. Clin Respir J. 2018; 12:2441–2445. doi: 10.1111/crj.12943.
  • Referans3. Manjunatha YC, Gupta AK. Tracheal Bronchus (Pig Bronchus). Indian J Pediatr 2010; 77:1037–1038. doi: 10.1007/s12098-010-0162-6.
  • Referans4. Han J, Xiang H, Ridley WE, Ridley LJ. Pig bronchus. 2018 The Royal Australian and New Zealand College of Radiologists. doi:10.1111/1754-9485.21_12785.
  • Referans5. Qi S, Zhang B, Yue Y, Shen J, Teng Y, Qian W, Wu J. Airflow in Tracheobronchial Tree of Subjects with Tracheal Bronchus Simulated Using CT Image Based Models and CFD Method. Med Syst. 2018; Mar 1;42(4):65. doi: 10.1007/s10916-017-0879-0.
  • Referans6. Lee DK, Kim YM, Kim HZ, Lim SH. Right upper lobe tracheal bronchus: anesthetic challenge in one-lung ventilated patients -A report of three cases- Korean J Anesthesiol 2013 May 64(5): 448-450.
  • Referans7. Barbetta C,Tamburini N, Marchi I, Forini G, Papi A. True tracheal bronchus. Anaesthesia 2016, 71, 846. doi:10.1111/anae.13531.
  • Referans8. Sindhwani G, Rawat J, Gupta M, Chandra S. Lung Cancer in “True Tracheal Bronchus” A Rare Coincidence. J Bronchol Intervent Pulmonol 2012;19:340–342.
  • Referans9. Ruiz EP, Aguilera PC, Valdivielso AI, Cárdenas SS, García YM, Frías JP. Tracheal bronchus diagnosed in children undergoing flexible bronchoscopy. Paediatric Respiratory Reviews 28 (2018) 26–30.
  • Referans10. Jain D, Bhardwaj N, Pareek A, Parikh B. Tracheal bronchus: an unusual cause of difficult ventilation. Can J Anesth/J Can Anesth (2017) 64:979–980 DOI 10.1007/s12630-017-0919-8.
  • Referans11. Wong F, Detterbeck F, Kurup V. Airway Management in Patients with Tracheal Bronchus. Images in Anesthesiology. Anesthesiology, 2016,125(2), 395. doi:10.1097/aln.0000000000001019.
  • Referans12. Schoenwolf GC, Blely SB, Brauer PR, Francis-West PH. Larsen’s Human Embryology, 5th Edt.(2015),Elsevier, 252-259.
  • Referans13. Moore KL, Persaud TVN, Torchia MG. The Developing Human-Clinically Oriented Embryology, 10th Edt.(2016), Elsevier, 195-200.
  • Referans14. Carlson BM, Human Embryology and Developmental Biology, 5th Edt.(2014), Elsevier, 359-362.
  • Referans15. Snowball J, Ambalavanan M, Whitsett J, Sinner D. Endodermal Wnt signaling is required for tracheal cartilage formation. Dev.Biol. 2015 Sep 1;405(1):56-70. doi: 10.1016/j.ydbio.2015.06.009.
  • Referans16. Mendognia P, Tosia D, Rossoa L, Palleschia A, Righia I, Montolia M, Marioloa AV, Nosottia M. Lung Transplant From Donor With Tracheal Bronchus: Case Report and Literature Review. Transplantation Proceedings, 51, 239e241 (2019).
  • Referans17. Ho AK, Ho AMH, Mizubuti GB. Blockage of the tracheal bronchus: effects on blood oxygen content, partial pressure of oxygen, and intrapulmonary shunt. Adv Physiol Educ 42: 383–386, 2018; doi:10.1152/advan.00017.2018.
  • Referans18. Lai KM, Hsieh MH, Lama F, Chen CY, Chen TL, Chang CC. Anesthesia for patients with tracheal bronchus. Asian Journal of Anesthesiology 55 (2017) 87-88.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Emre Can Çelebioğlu This is me 0000-0002-1580-7064

Selma Çalışkan 0000-0002-5839-3172

Sinem Akkaşoğlu 0000-0002-3371-4734

Hilal Göktürk Nakkaş 0000-0003-0901-8875

İbrahim Tanzer Sancak This is me 0000-0003-1968-7714

Publication Date March 31, 2020
Acceptance Date March 20, 2020
Published in Issue Year 2020 Volume: 10 Issue: 1

Cite

AMA Çelebioğlu EC, Çalışkan S, Akkaşoğlu S, Göktürk Nakkaş H, Sancak İT. Tracheal Bronchus; A Computed Tomography Study. J Contemp Med. March 2020;10(1):40-44. doi:10.16899/jcm.619857