Communicating Bronchopulmonary Foregut Malformation Presenting as Esophageal Bronchus: Imaging and Surgical Correlation

Communicating bronchopulmonary foregut malformations (CBPFMs) are rare congenital anomalies resulting from abnormal communication between the respiratory tract and foregut. Esophageal bronchus (Srikanth Group III) is a subtype in which a lobar or segmental bronchus arises directly from the esophagus, while the remaining tracheobronchial tree is preserved. We report a term female infant with an antenatal history of polyhydramnios who presented in early infancy with cough during feeds, recurrent pneumonia, respiratory distress, and failure to thrive. Contrast-enhanced multidetector computed tomography with oral contrast revealed a hypoplastic left lower lobe supplied by an aberrant bronchus arising from the distal thoracic esophagus, confirming the diagnosis of esophageal bronchus. The patient underwent left lower lobectomy with division of the esophageal communication. This case highlights the role of imaging in accurately diagnosing esophageal bronchus, distinguishing it from other CBPFMs, and guiding surgical management.