A rare case of coexisting left pulmonary hypoplasia and right tracheal bronchus.

To cite: Shahul HA, Manu MK, Mohapatra AK. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2014-205008 DESCRIPTION A 23-year-old woman presented with a 10-year history of recurrent breathlessness and cough. Her medical history was unremarkable except for asthma, which was under control. General physical examination was normal. A respiratory system examination revealed mediastinal shift to left with features of volume loss of the left hemithorax. Breath sounds were reduced and a dull percussion note was present over the left basal areas. Routine blood investigations were normal. Chest radiograph (figure 1) revealed mediastinal shift to left with volume loss of the left hemithorax and elevated left hemidiaphragm. Sputum Ziehl-Neelsen staining for mycobacteria and bacterial culture were negative. Contrast-enhanced CT (CECT) of the thorax revealed a right displaced tracheal bronchus (figure 2A), a left pulmonary arterial tree with small branches (figure 2B), a left bronchial tree with reduced calibre (figure 2C), reduced volume of left lung and mediastinal shift to left. The right lung was hyperinflated and herniating to the opposite side (figure 2D). The threedimensional image reconstruct (figure 3A, B) clearly demarcated the above findings. CT features were consistent with left pulmonary hypoplasia and a coexisting right tracheal bronchus. Abdominal and pelvic sonography, ECG and echocardiogram were normal. The patient was managed