Morphological Variations in the Tracheobronchial Tree, Pulmonary Venous Pattern and Fissural Anatomy: A Cadaveric Study

Background: Variations in the tracheobronchial tree are of considerable clinical importance because of their implications in radiological interpretation, bronchoscopy, thoracic surgery and anesthetic management. Detailed anatomical knowledge helps prevent diagnostic errors and intraoperative complications.

Aim: To document variations in the trachea bronchial tree, pulmonary veins, and fissural anatomy observed during routine cadaveric dissection and to assess their embryological and clinical significance.

Materials and Methods: The present study was conducted during routine cadaveric dissection for undergraduate (MBBS) teaching. A total of 68 lungs were examined for variations in bronchial branching pattern, pulmonary venous drainage and fissural morphology.

Results: Variations in bronchial pattern were observed in 24 of 68 lungs (35.3%). An additional bronchial branch arising directly from the right main bronchus and supplying part of the upper lobe (tracheal/eparterial bronchus) was identified in11 lungs (16.2%). An accessory lobar bronchus causing atypical segmentation in the left lung was noted in 13 lungs (19.1%). Variations in pulmonary venous drainage were observed in 4 lungs (5.9%), involving altered superior or inferior pulmonary vein branches (two right and two left lungs). Absence of fissures was noted in 2 lungs (2.9%).

Conclusion: These findings emphasize the need for awareness so bronchial, vascular, and fissural variations for accurate radiological evaluation, safe bronchoscopic procedures, and effective surgical planning. Understanding their developmental basis enhances clinical preparedness and reduces the risk of procedural complications