The ectopic tracheal bronchus: management of a child by excision and segmental pulmonary resection.

Smelt7 described several variations of the congenital anomaly which they termed tracheal lobe. Essentially, an otherwise normal right upper lobe bronchus originates above the tracheal carina or bifurcation and provides the customary three segmental divisions. There may, however, be a complete duplication of the right upper lobe bronchus by an ectopic tracheal bronchus. Usually the anterior and posterior bronchopulmonary segments are subserved by the normal upper lobe bronchus, the ectopic tracheal bronchial evagination serving the apical segment only.1 If drainage of the appropriate bronchopulmonary segment is impaired, or bronchiectasis, cystic change or emphysema develop because of stenosis of the origin of the ectopic bronchus, then the patient may develop recurrent episodes of pneumonia or dyspnea. The purpose of this publication is to present a child in whom recurrent episodes of right upper lobe pneumonia led to investigation and diagnosis of an ectopic tracheal bronchus serving the right apical segment, with cure of the condition by thoracotomy and resection of the ectopic bronchus and its associated apical pulmonary segment.