CRP6 CLINICAL CHARACTERISTICS OF CHILDREN WITH TRACHEAL BRONCHUS: A CASE SERIES

Ooi Chia Lin, Amanil ‘Ula Hassan
Pediatric department, Hospital Sultanah Bahiyah, Kedah, Malaysia

Introduction
Tracheal bronchus (TB) is a rare congenital malformation of the trachea-bronchial tree with a bronchus originating from the trachea. It is reported in 0.1- 2% of the general population. The diagnosis of tracheal bronchus can be made by rigid and flexible bronchoscopy or by computed tomography.  

Objectives
This study aims to describe the anatomical characteristics of the paediatric patients with tracheal bronchus and to analyze the associated symptoms, and its clinical significance.

Methodology
Retrospective case series study of 5 children diagnosed with tracheal bronchus from January 2023 till December 2024.

Results
The median age at diagnosis was 17.5 months (range, 5-32months) and the majority are male (80%) and mostly were born at term (4 of 5 patients). The predominant presenting symptoms are recurrent pneumonia in three of five patient (60%) and all were detected to have recurrent right upper lobe atelectasis in serial chest imaging. Two of them (40%) underwent flexible bronchoscopy and contrasted enhanced CT thorax were performed in all patients. The commonest variant is type 1 variant (3/5, 60%). Three of five patients (60%) had associated congenital heart disease.  Four patients required home positive airway pressure (PAP) therapy with median duration of usage were 11months (6-14month). None of them were surgically intervened, and no mortality recorded. 

Conclusion
Tracheal bronchus is a rare morphological anomaly of the tracheobronchial tree and most is associated with other birth defects such as vascular abnormality, and congenital heart malformation. The diagnosis of tracheal bronchus sometimes poses challenges and most common presentations are recurrent pneumonia and persistent atelectasis and these warrant active treatments.