Prevalence of tracheobronchial anomalies among patients undergoing fibreoptic bronchoscopy: a retrospective analysis from a tertiary care hospital in Wayanad, Kerala, India

Amitha Sunny, Ravindran Chetambath, Sanjeev Shivashankaran, Muhammed Aslam


Background: Tracheobronchial anomalies are a rare clinical entity and often asymptomatic in nature. Some patients may experience symptoms such as cough, recurrent pneumonia or hemoptysis. Knowledge and understanding of tracheobronchial variations have important implications for diagnosis of symptomatic patients and performing certain procedures, including bronchoscopy and endotracheal intubation. Objective was to study the prevalence of tracheobronchial anomalies detected during routine bronchoscopy in a tertiary care setting.

Methods: Retrospective analysis of hospital data of patients undergoing fibreoptic bronchoscopy for one year in a tertiary care setting.

Results: There were 149 bronchoscopies evaluated. Total of 41 anomalies were detected in 34 (22.8%) subjects. The most common anomaly was bronchial diverticula.

Conclusions: This retrospective study takes stock of various tracheobronchial anomalies among subjects who underwent bronchoscopy in a tertiary care hospital in Wayanad, North Malabar. This study revealed major tracheobronchial anomalies in 22.8% of subjects which is higher when compared to previous studies. This is particularly important due to the fact that Wayanad is a backward hilly district and tribal community constitutes 20% of its population.


Bronchial diverticula, Cardiac bronchus, Tracheal bronchus

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Ghaye B, Szapiro D, Fanchamps JM, Dondelinger RF. Congenital bronchial abnormalities revisited. Radio Graphics. 2001;21(1):105-19.

Lemoine JM, Gagnon A. Principaux modes de division et anomalies anatomiques de la trachée et des bronches. Bronches. 1952; 2:409-21.

Laforet EG, Starkey GWB, Scheff S. Anomalies of upper lobe bronchial distribution. J Thorac Cardiovasc Surg. 1962;43:595-606.

Atwell SW. Major anomalies of the tracheobronchial tree, with a list of the minor anomalies. Dis Chest. 1967;52:611-15.

Kubik S, Müntener M. Bronchusanomalien. Tracheale, eparterielle, und präeparterielle bronchi. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 1971;114:145-63.

Evans JA. Aberrant bronchi and cardiovascular anomalies. Am J Med Genet. 1990;35(1):46-54.

Hutchins GM, Haupt HM, Moore GW. A proposed mechanism for the early development of the human tracheobronchial tree. Anat Rec. 1981;201(4):635-40.

Guillaume C, Baptist M, Elodie C. Tracheobronchial branching abnormalities: Lobe based classification scheme. Radiographics. 2016;36:2.

Ming Z, Lin Z. Evaluation of tracheal bronchus in Chinese children using multidetector CT. Pediatr Radiol. 2007;37(12):1230-34.

Boyden EA. Segmental anatomy of the lungs. A study of the patterns of the segmental bronchi and related pulmonary vessels. The Blakiston Division. 1955:185-200.

Applegate KE, Goske MJ, Pierce G, Murphy D. Situs revisited: imaging of the heterotaxy syndrome. Radio Graphics. 1999;19(4):837-54.

O’Sullivan BP, Frassica JJ, Rayder SM. Tracheal bronchus: a cause of prolonged atelectasis in intubated children. Chest. 1998;113(2):537-40.

Panigada S, Sacco O, Girosi D, Tomà P, Rossi GA. Recurrent severe lower respiratory tract infections in a child with abnormal tracheal morphology. PediatrPulmonol. 2009;44(2):192-4.

Brock RC. The anatomy of the bronchial tree. London, England: Oxford University Press. 1946;34(134):221-221.

Ghaye B, Kos X, Dondelinger RF. Accessory cardiac bronchus: 3D CT demonstration in nine cases. Eur Radiol. 1999;9(1):45-8.