Tesfamaryam Behaylu, Tsehay Belayneh, Kemaw Nadew, Abera Yisehak
Internal Medicine, Besheno Primary Hospital, Halaba, Central Ethiopia, Ethiopia.
Besheno Primary Hospital, Halaba, Central Ethiopia, Ethiopia.
J Med Case Rep. 2025 Apr 15;19(1):175. doi: 10.1186/s13256-025-05213-2.
Tracheal bronchus and accessory cardiac bronchus are rare congenital anomalies of the tracheobronchial tree. Tracheal bronchus is a congenital anomaly in which the bronchus supplying all or part of the upper lobe originates from the trachea, carina, or another bronchus, while accessory cardiac bronchus arises from the medial wall of the bronchus intermedius. To our knowledge, this is the first reported case from Africa describing the simultaneous occurrence of bilateral tracheal bronchi and accessory cardiac bronchus.
A 45-year-old, non-smoking Ethiopian male of Halaba ethnicity presented with a chief complaint of a dry cough lasting 2 weeks. Chest examination revealed stony dullness and absent air entry over the right lower lung field. A non-contrast chest computed tomography scan showed right upper lobe pneumonia with empyema. Notably, the computed tomography scan also revealed bilateral tracheal bronchi supplying both the right and left upper lobes and an accessory cardiac bronchus. The patient was treated with broad-spectrum antibiotics and chest tube drainage for empyema and was discharged in an improved condition. Four months after discharge the patient returned to his pre-hospitalization activity level.
This case highlights the importance of recognizing these congenital anomalies, especially in patients with recurrent respiratory symptoms, to ensure appropriate diagnosis, prevention, and management of associated complications.
气管支气管和副心支气管是气管支气管树罕见的先天性异常。气管支气管是一种先天性异常，其中供应全部或部分上叶的支气管起源于气管、隆突或另一个支气管，而副心支气管起源于中间支气管的内侧壁。据我们所知，这是非洲首次报道的同时出现双侧气管支气管和副心支气管的病例。
一名45岁、不吸烟、哈拉巴族的埃塞俄比亚男性，主要症状为干咳持续2周。胸部检查发现右下肺野呈实音，呼吸音消失。胸部非增强计算机断层扫描显示右上叶肺炎合并脓胸。值得注意的是，计算机断层扫描还显示双侧气管支气管分别供应右肺和左肺上叶以及一条副心支气管。患者接受了广谱抗生素治疗和胸腔闭式引流以治疗脓胸，出院时病情有所改善。出院四个月后，患者恢复到住院前的活动水平。
本病例强调了认识这些先天性异常的重要性，特别是对于有反复呼吸道症状的患者，以确保对相关并发症进行适当的诊断、预防和管理。
