Communicating bronchopulmonary foregut malformation type IA: radiologic anatomy and clinical dilemmas

Surg Radiol Anat. 2015 Dec;37(10):1251-6. doi: 10.1007/s00276-015-1504-x. Epub 2015 Jun 16.

Abstract

Background: Communicating bronchopulmonary foregut malformation (CBPFM) type IA is extremely rare and is associated with a high mortality rate. This malformation manifests with communication between the lung and the foregut, and this can lead to esophageal atresia and tracheoesophageal fistula (EA-TEF) to the distal pouch.

Purpose: To detail radiographic findings of CBPFM type IA cases and to summarize an appropriate therapeutic strategy for the management of this disorder.

Methods: Medical data for two patients with CBPFM type IA were retrospectively reviewed with regard to radiographic characteristics, therapy, and outcome.

Results: Both cases were initially misdiagnosed due to the presence of EA-TEF. Unusual atelectasis of the lateral lung was observed in chest radiographs, while non-aerated hypoplastic right lung and agenesis of the right main bronchus were detected by computed tomography. A final diagnosis was made by esophagogram. Only one patient survived following surgery.

Conclusion: CBPFM type IA is a rare condition and is extremely difficult to diagnose. However, CBPFM type IA should be suspected in patients manifesting EA and atelectasis of a unilateral lung on a chest radiograph. The decision to perform a pneumonectomy or bronchoplasty depends on the degree of exiting permitted due to pulmonary damage assessed by computed tomography.

Keywords: Congenital bronchopulmonary foregut malformations; Esophageal atresia; Sequestered lung; Tracheoesophageal fistula.

Publication types

  • Case Reports

MeSH terms

  • Bronchi / abnormalities*
  • Bronchi / surgery
  • Bronchography*
  • Esophageal Atresia / diagnostic imaging*
  • Esophageal Atresia / surgery
  • Fatal Outcome
  • Humans
  • Infant, Newborn
  • Lung / abnormalities*
  • Lung / diagnostic imaging*
  • Lung / surgery
  • Male
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Tracheoesophageal Fistula / diagnostic imaging*
  • Tracheoesophageal Fistula / surgery