Concurrent tracheal bronchus, tracheal stenosis, and pulmonary sequestration: A case report and mini‑review of the literature

Tracheal bronchus (TB) is an abnormal bronchus arising directly from the tracheal wall above the carina, supplying the upper lobes. This anomaly is occasionally associated with congenital tracheal stenosis (TS), with a reported incidence of 11.9‑24.7% in affected patients. The simultaneous occurrence of TB, congenital TS and pulmonary sequestration (PS) in a single patient is extremely rare. The present study describes the case of a 4‑year‑old boy who presented with shortness of breath and stridor. He had a lifelong history of recurrent episodes, initially misdiagnosed as asthma. A clinical examination revealed tachypnea, audible stridor and fever (37.9˚C), with an elevated white blood cell count and C‑reactive protein levels. A chest computed tomography scan demonstrated TB with severe TS, and the TB was supplying an additional lobar sequestration in the right lung. The patient was treated with oxygen, intravenous fluids, antibiotics and low‑dose steroids; however, he was lost to follow‑up before definitive surgical management. In addition, a literature review of articles from the PubMed and Google Scholar databases identified no previous reports of concurrent TB, congenital TS and PS in a single patient. However, six studies described 41 cases of TB associated with either congenital TS or PS. In summary, the coexistence of TB, congenital TS and PS is exceptionally rare, and may easily be misdiagnosed as common respiratory conditions, such as asthma. It is essential to consider such rare congenital anomalies in children presenting with persistent stridor or unexplained respiratory symptoms.