Left pulmonary artery sling with tracheal stenosis

We present the case of a 4-year-old girl, bronchofiberscopy (scope diameter 2.8mm): one third below of trachea, which was divided into two orifices. The orifice on the right side was larger and divided into two suborifices. The left orifice was stenosis and could not pass the bronchoscope. Whole trachea mucosa was red and edema, and could not observe the cartilage ring of trachea. Chest X-ray: infiltration of right lower lobe. Chest CT multiple probes with contrast injection confirmed that: At the sixth to seventh thoracic vertebral level, the left pulmonary artery was arisen from the right pulmonary artery then passed in between the behind trachea and anterior oesophagus to reach the left lung hilar. And at the fourth to fifth thoracic vertebral level, the right upper bronchus was arisen from trachea and then the trachea was shrunk diameter to reach the left lung hilar, at the end, the trachea divided 2 bronchi: left main bronchus and “bridging bronchus”. That bronchus from left lung hilar returned to the right lung. This patient was diagnosed birth defect: Left pulmonary artery sling with trachea stenosis, type IIA.