Bronchial atresia

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Bronchial atresia (BA) is a developmental anomaly characterised by focal obliteration of the proximal segment of a bronchus.

Pathology

The bronchi distal to the atresia become filled with mucus and may form a mucocoele. 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.

Clinical presentation

Bronchial atresia is usually asymptomatic, as with this case found incidentally on the CT chest of a trauma patient. If symptomatic, it may cause shortness of breath, cough or rarely infection.

Radiographic features

HRCT

atretic bronchial stump(s) often become mucus plugged and can give a finger in glove appearance
distal lung parenchyma supplied by the atretic segment can be emphysematous due to air trapping: 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.

Differential diagnosis

congenital lobar emphysema (CLE)
allergic bronchopulmonary aspergillosis (ABPA): for finger in glove appearance

~~-<li>distal lung parenchyma supplied by the atretic segment can be emphysematous due to air trapping : air entering through <a href="/articles/pores-of-kohn">pores of Kohn</a>~~
+<li>distal lung parenchyma supplied by the atretic segment can be emphysematous due to air trapping: air entering through <a href="/articles/pores-of-kohn">pores of Kohn</a>
~~-<a href="/articles/allergic-bronchopulmonary-aspergillosis">allergic bronchopulmonary aspergillosis (ABPA)</a> : for finger in glove appearance</li>~~
+<a href="/articles/allergic-bronchopulmonary-aspergillosis">allergic bronchopulmonary aspergillosis (ABPA)</a>: for finger in glove appearance</li>

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