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Elucidating the anatomy of a rare communicating bronchopulmonary foregut malformation (CBPFM) in a preschool child
  1. Niveditha Shama1,
  2. John Mathai1,
  3. Ekta Rai2 and
  4. Thomas Alex Kodiatte3
  1. 1Paediatric Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  2. 2Anaesthesia, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  3. 3General Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  1. Correspondence to Dr Niveditha Shama; nivi.here{at}gmail.com

Abstract

Communicating bronchopulmonary foregut malformations (CBPFMs) are complex and rare anomalies. Their characteristic feature is an anomalous communication between the respiratory system (trachea, lung or bronchus) on one side and the gastrointestinal tract (oesophagus or stomach) on the other. Though acquired CBPFMs are known, the large majority of them are congenital and single. CBPFMs often go undetected even at surgery and require more than one operation before they are successfully addressed. This is because the symptomatology of CBPFM resembles the more common oesophageal atresia (OA) with tracheoesophageal fistula, wherein it may coexist. We report a patient with OA who had a rare form of CBPFM where the upper lobe of the right lung communicated with the upper oesophagus. This account highlights a novel method of working out the uncertain anatomy, in such cases. There may be associated anomalies of the lung parenchyma and vasculature usually involving the pulmonary arterial supply to the affected lung. Clinical, radiological, endoscopic and pathological characterisation permit precise diagnosis in most instances, with an occasional case that defies definition.

  • endoscopy
  • paediatric surgery
  • cardiothoracic surgery
  • respiratory medicine
  • congenital disorders

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Footnotes

  • Contributors All authors served as editors of the article. NS was the main author. JM, apart from serving as mentor and adviser, also contributed significantly with the writing and formatting of the manuscript. ER took care of the patient perioperatively with respect to airway and anaesthetic management. She also reviewed and guided the description of anaesthestic techniques used in the operation. TAK interpreted the histopathological specimen and slides. He also helped procure photomicrographs and provided written captions. NS and JM took direct care of the patient presented in the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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