Bronchial atresia
Updates to Article Attributes
Bronchial atresia is a developmental anomaly characterised by focal obliteration of the proximal segment of a bronchus.
Clinical presentation
Bronchial atresia is usually asymptomatic, and may be found incidentally. If symptomatic, it may cause shortness of breath, cough or rarely infection.
Pathology
The exact cause of bronchial atresia is not well known. Focal bronchial interruption appears to occur before birth. As the bronchial pattern is entirely normal distal to the site of stenosis, it has been suggested that atresia is probably secondary to a traumatic event during fetal life rather than a result of abnormal growth and development 5.
The bronchi distal to the atresia become filled with mucus and may form a mucocoele/bronchocoele. The lung distal to the atretic bronchus develops normally but is overinflated due to collateral air drift with air trapping.
Location
It is typically at the segmental or subsegmental level. It can involve any lobe but most commonly occurs at the apico-posterior segment of the left upper lobe, 2 followed by right upper lobe..
Radiographic features
CT
- atretic bronchial stump(s) often become(s) mucus plugged and can give a finger in glove appearance
- distal lung parenchyma supplied by the atretic segment can be hyperlucent due to oligemia and air trapping with air entering through pores of Kohn
- HRCT features are usually typical but segmental resection may be done to rule out a rare possibility of underlying small malignancy as the cause of obstruction 3.
Complications
Althought it is usually an incidental finding but it may cause recurrent infections in 20% of patients.
History and etymology
It is thought have been was first described in 1953 by Ramsay in a series of patients with cystic lung disease 5.
Differential diagnosis
- congenital lobar emphysema (CLE)
- allergic bronchopulmonary aspergillosis (ABPA): for finger in glove appearance
-<li>atretic bronchial stump(s) often become(s) mucus plugged and can give a <a href="/articles/finger-in-glove-sign">finger in glove</a> appearance</li>- +<li>atretic bronchial stump(s) often become(s) mucus plugged and can give a <a href="/articles/finger-in-glove-sign-lung">finger in glove</a> appearance</li>
Image 3 CT (lung window) ( update )
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