Esophageal bronchus | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Esophageal bronchus

Image from an upper GI examination in a neonate with a history of recurrent pneumonia shows the right lower lobe bronchus arising from the esophagus. An esophageal bronchus is an incredibly rare congenital bronchopulmonary foregut malformation. Esophageal bronchi are more common on the right side and occur more frequently in girls. They are associated with other anomalies including duodenal atresia, distal tracheoesophageal fistula, esophageal atresia, and congenital heart disease.

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Contrast enema obtained in a neonate with abdominal distension and failure to pass meconium shows a micro colon. Contrast refluxes into the ileum in the right lower quadrant. However, it never is able to reflux into the dilated and distended upstream bowel loops. This is typical of ileal atresia. During surgical correction, it is important for the surgeon to “run the bowel” looking for other atresia. #TummyTuesday

Image from an upper GI examination in a neonate with a history of recurrent pneumonia shows the right lower lobe bronchus arising from the esophagus. An esophageal bronchus is an incredibly rare congenital bronchopulmonary foregut malformation. Esophageal bronchi are more common on the right side and occur more frequently in girls. They are associated with other anomalies including duodenal atresia, distal tracheoesophageal fistula, esophageal atresia, and congenital heart disease. #ThoraxThursday #ThoracicThursday

Images from a water-soluble contrast enema show a microcolon (dashed arrow) which abruptly terminates in the left upper quadrant (arrow). Contrast never extends to the markedly dilated bowel segment (arrowhead). The most common causes of microcolon include ileal atresia, meconium ileus, and occasionally total colonic Hirschsprung disease. In this patient, the microcolon was caused by colonic atresia. Colonic atresia is a rare form of intestinal atresia. It is associated with other congenital anomalies in approximately 50% of patients. Other abdominal anomalies include abdominal wall defects, other intestinal atresias, Hirschsprung disease, and malrotation.

Coronal chest CT scan demonstrates left upper lobe hyperinflation (arrow) with distinct demarcation at the major fissure (arrowhead), indicative of congenital lobar overinflation. Differential diagnosis considerations for such a finding include bronchial atresia, congenital pulmonary airway malformation, and pleuropulmonary blastoma. Congenital lobar overinflation predominantly affects the left upper lobe. While the presentation might resemble bronchial atresia, the absence of an opacified bronchus aids in distinguishing between the two conditions.