Bronchial malformations in children: anatomical diversity and clinical-imaging features

<bold>Aim:</bold> To study the anatomical features of bronchial malformations in clinical and imaging context in children. <bold>Methods:</bold>The study was conducted on a sample of 18 children with congenital bronchial malformations, confirmed by thoracic CT scans (HRCT). There were 15 children with tracheal bronchus, 2 children with bronchial stenosis from vascular rings, 1 child with bridging bronchus. The age of the children from the 2 months to 11 years; 8 boys and 10 girls. <bold>Results:</bold>In all the children, the tracheal bronchus emerged from the right side of the trachea. Among them, 26.6% showed the bronchus starting from the middle segment of the trachea, in 14.3%:95%CI 1.8-42.8 from the lower segment, in 64.3%:95%CI 35.1-87.2 - near the tracheal bifurcation. Children with a bridging bronchus exhibited the emergence of the right middle and lower lobe bronchi through a common bronchus from the left main bronchus. The children had pneumonic infiltration in 22.2% of cases, changes resembling "ground glass" in 14.3%:95%CI 1.8-42.8, segmental atelectasis in 33.3%, and pulmonary fibrosis in 21.4%:95% CI 4.7-50.8. Children with bronchial malformations exhibited severe symptoms including progressive respiratory failure and recurrent lung infections. These children showed clinical signs of respiratory failure due to the narrow caliber of the trachea and bronchi in their early years, have difficulty tolerating stenotic lesions of the airways, and often require surgical treatment. <bold>Conclusions:</bold> HRCT imaging research provides valuable information in specifying the anatomical features of bronchial malformations, the type of bronchial anomalies, the degree of stenosis, and pulmonary complications.