Study of variations in the broncho-arterial pedicles of the upper right lung lobe

Bronchial distribution and functional arterial vascularization of the upper lobe of the right lung are subject to many anatomical variations. The control of these variations is essential for endoscopic and agiographic examinations. It also offers a better guarantee for safe and controlled surgery. In this preliminary work, the exploitation of 15 heart-lung blocks treated by the injection corrosion method allowed us to study the general arrangement of the broncho-arteries of the right upper lung lobe and their anatomical variations in the Senegalese population. Our results were as follows: the right upper lobar bronchus was born on average at 1.25 cm from the tracheal bifurcation, with an average length of 1.13 cm. It ended with trifurcation into apical (B1), dorsal (B2) and ventral (B3) segmental bronchi in 10 cases (66.66%); in 3 cases (20%), it ended with bifurcation into the dorsal segmental bronchus and the apico-ventral trunk (B1+B3) (1 case), the apico-dorsal trunk (B1+B2) and the ventral segmental bronchus (B3), finally, in ventral and dorsal segmentary bronchi giving each one an apical branch (1 case); in a last case, it ended by quadrifurcation, giving an external parabronche. The right upper lobe was vascularized by 1 to 4 arteries, with eight modes of vascularization. It received more frequently two arteries. The anterior mediastinal artery was the most common (100%). These results allowed us to discuss anatomical variations in the bronchial tree of the right upper lung lobe and the pulmonary arterial distribution in that lobe. These variations must be taken into account during endoscopic examinations of imaging and surgery of pulmonary excision, under penalty of accidents.