Doolittle Andrew M, Mair Eric A
Otolaryngology-Head and Neck Surgery Service, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Otolaryngol Head Neck Surg. 2002 Mar;126(3):240-3. doi: 10.1067/mhn.2002.122703.
Tracheal bronchus (bronchus suis) is an unusual congenital anomaly in which the right upper lobe has its origin in the trachea rather than distal to the carina. We sought to analyze the anatomy, presentation, and airway management principles of tracheal bronchi, and we present the first endoscopically documented tracheal diverticulum.
STUDY DESIGN/METHODS: Retrospective case series.
The tracheal bronchus is located at the junction of the mid and distal thirds of the right lateral trachea, is more common in males and children with other congenital anomalies, and may be associated with right main bronchus stenosis. Bronchoscopy provides a clear definitive view of the anomaly, which we found in 5 children during a 12-year period (0.5% of pediatric bronchoscopy procedures). We illustrate 3 types of tracheal bronchi: (1) vestigial tracheal diverticulum (newly described), (2) high apical lobe, and (3) fully developed supranumerary aerated tracheal bronchus. Endoscopic documentation of each type is presented. Children with tracheal bronchi may present with stridor, cough, and/or recurrent right-sided pneumonia and/or to have foreign body aspiration ruled out. Treatment is based on the severity of symptoms and ranges from observation to right upper lobectomy.
Otolaryngologists should be aware of the tracheal bronchus, to include classification, endoscopic analysis, and airway management of this uncommon anomaly. Bronchoscopy with selected radiographic imaging allows the otolaryngologist to fully evaluate the child with a tracheal bronchus and to present timely therapeutic options.
气管支气管（猪支气管）是一种罕见的先天性异常，其中右上叶起源于气管而非隆突远端。我们试图分析气管支气管的解剖结构、临床表现及气道管理原则，并展示首例经内镜记录的气管憩室。
研究设计/方法：回顾性病例系列研究。
气管支气管位于右侧气管中、远三分之一交界处，在男性及合并其他先天性异常的儿童中更为常见，可能与右主支气管狭窄有关。支气管镜检查能清晰明确地观察到这种异常，我们在12年期间的5名儿童中发现了这种情况（占小儿支气管镜检查病例的0.5%）。我们阐述了3种类型的气管支气管：（1）残留气管憩室（新描述类型），（2）高位尖叶型，（3）完全发育的额外充气气管支气管。每种类型均有内镜记录展示。患有气管支气管的儿童可能表现为喘鸣、咳嗽和/或反复右侧肺炎，和/或需要排除异物吸入。治疗基于症状的严重程度，范围从观察到右上叶切除术。
耳鼻喉科医生应了解气管支气管，包括这种罕见异常的分类、内镜分析及气道管理。支气管镜检查结合特定的影像学检查可使耳鼻喉科医生全面评估患有气管支气管的儿童，并及时提供治疗方案。
