Tracheal bronchus: a cause of unexplained prolonged hypoxemia during ventilation.

The spectrum of disorders involving the tracheobronchial tree is diverse, with some of the conditions unique to the pediatric population. Despite the "airway first" maxim, many such disorders are missed initially. Tracheal bronchus is one such condition that comes to notice by persistent right upper lobe atelectasis, pneumothorax, recurrent pneumonia, chronic bronchitis, and prolonged ventilation. This anatomic variant in a patient with cyanotic congenital heart disease is reported. For this patient, timely identification of tracheal bronchus allowed appropriate changes in airway management and was life saving.