CTICasesChronically Obstructed Tracheal Bronchus
Imaging findings
Chest CT shows a blind-ending pouch arising from the right lateral wall of the trachea just superior to the azygos arch. Distally in the apical right upper lobe, there is a localized region of persistent mucus plugging and bronchiolectasis. Comparison with an older scan reveals that this blind-ending pouch previously communicated directly with the right upper lobe airway as a patent tracheal bronchus, which has since chronically obstructed and closed itself off.
Key takeaways
A tracheal bronchus is a congenital tracheobronchial anomaly in which an accessory bronchus originates directly from the lateral wall of the trachea. Because these anomalous bronchi often arise near the azygos arch and must course around it, they frequently possess a slit-like, narrowed orifice. Over time, chronic irritation, localized infection, or mechanical folding can cause the orifice to completely close off, resulting in chronic distal mucus retention, recurrent localized infections, and a blind-ending tracheal diverticulum.
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