Clinical Aspects of Congenital Anomalies of the Trachea and Bronchi

¹ The Department of Otolaryngology, University of Illinois, College of Medicine, St. Luke's Hospital and the Department of Bronchoesophagology, Children's Memorial Hospital, Chicago.

Congenital anomalies of the lower respiratory tract are described and classified and the clinical aspects are then discussed. Anomalies of the trachea include constrictions and enlargements, evaginations and outgrowths and abnormal bifurcation or deviation. Anomalies of the bronchi and lungs which are described include agenesis, constrictions, evaginations, subnumerary and supernumerary bronchi, lobes and fissures and anomalous bronchial and lung tissue attached to the respiratory or other systems. The clinical significance of the anomalies is found to be greatest in the newborn period when the acute respiratory symptoms they may cause require prompt diagnostic studies, including bronchoscopy and exploratory thoracotomy. Particular stress is placed on the clinical picture caused by varying degrees of bronchial obstruction due to cardiac and vascular malformations. The discussion emphasizes the importance of teamwork between pediatrician, roentgenologist, bronchologist and thoracic surgeon in the management of the interesting problem presented, and the fact that when one gross anomaly is found, there are frequently other serious malformations of other systems that should also be recognized.