Presentation
CT performed for the assessment of the upper airways following long term tracheostomy. Prolonged ITU stay led to tracheostomy insertion.
Patient Data
Tracheostomy.
Smaller additional bronchus arising from the supra-carinal trachea on the right immediately above the right main bronchus, supplying the right upper lobe.
Minor lingula and right middle lobe atelectasis.
Bronchus suis showed bifurcating from the trachea before the origin of the right main bronchus.
Case Discussion
A tracheal bronchus (with some variations also known as a pig bronchus) is an anatomical variant where an accessory bronchus originates directly from the supracarinal trachea. The latter term (pig bronchus or bronchus suis) is often given when the entire upper lobe (usually right side) is supplied by this bronchus.
It is nearly always an incidental finding, as in this case. It may be identified on bronchoscopy or CT.