Tracheal bronchus associated with VACTERL.

Tracheal bronchus (TB) associated with VACTERL has not been reported previously. A 5-month-old girl with VACTERL association was ventilator-dependent following surgical closure of a patent ductus arteriosus (PDA). Chest radiographs showed persistent hyperinflation of the right upper lobe. Bronchoscopy showed a laterally displaced right main bronchus with stenosis and malacia of the left main bronchus. Dynamic bronchography revealed a TB associated with tracheal stenosis and malacia below the abnormal bronchus. TB may represent an additional tracheal (T) anomaly in VACTERL association. Dynamic bronchography is a useful diagnostic tool in tracheobronchial anomalies.

Conclusions: TB may represent an "associated" tracheal (T) anomaly in children with VACTERL association. Bronchoscopy may fail to diagnose an ectopic bronchus. Dynamic bronchography is a useful diagnostic tool in tracheobronchial anomalies.