LAUSR

A previous healthy 78-year-old woman underwent a medical checkup. She was afebrile and had no respiratory symptoms. However, chest computed tomography revealed an incidental finding of right tracheal bronchus (Picture, arrowheads). Tracheal bronchus arises most often from the right tracheal wall above the carina and supplies the right upper lobe (1). The reported incidence is 0.06% in an adult population (2). Patients are usually asymptomatic, but some may have recurrent infection (e.g., pneumonia, bronchitis) (1). Asymptomatic tracheal bronchi are incidentally found during bronchoscopy or tomography and require no treatment (1). Symptomatic patients are indicated for any appropriate medical intervention, including lobectomy (1). The identification of a tracheal bronchus is important in patients undergoing endotracheal intubation, as accidental occlusion of a tracheal bronchus by an endotracheal tube can cause atelectasis, post-obstructive pneumonia, or even respiratory failure (1). Pre-operative recognition of a tracheal bronchus can help ensure safe airway management (1).