[Troubled endotracheal intubation: an adult case of anomalous tracheal bronchus].

We experienced troubled endotracheal intubation in an adult patient with asymptomatic tracheal bronchus. The breath sounds of the right upper lobe were found to be absent right after the placement of a tracheal tube. An anomalous tracheal bronchus (displaced right upper lobar bronchus originating about 1 cm above carina) was found by fiberoptic bronchoscopy. The length of trachea of the patient was about 6 cm shorter than that of the normal value of adult male, which significantly reduced the safe range of positioning a tracheal tube. In a patient with this anomaly, who is otherwise healthy, a placement of a tracheal tube may cause pulmonary complications. Thus, as a diminished breath sound is found to be located at the upper right lobe after endotracheal intubation, we have to think of tracheal bronchus as one of the possible causes.