Background and Objectives: BronchoPulmonary foregut malformations are a group of rare congenital anomalies affecting the respiratory and upper gastro-intestinal tract. Congenital Broncho-esophageal fistula (BEF) if not associated with esophageal atresia is a rare anomaly. Further BEF in which the right main stem bronchus originates from the esophagus with lung hypoplasia is a very rare anomaly. Only 12 cases have been reported up to date.Case Report: The patient, a 3-month-old infant, was admitted with cough, wheezing, tachypena and FTT. Chest X-ray revealed right lung aplasia. Chest CT scan demonstrated lung hypoplasia. Perfusion scan demonstrated negligible function on the right lung. Rigid bronchoscopy showed absence of right main bronchus. An upper GI contrast study demonstrated a right bronchoesophageal fistula. Right posterolateral thoracotomy was discovered as the right main bronchus originating from the lower third of the esophagus communicated with a hypoplastic of the right lung. The right lung was removed and fistula was ligated.Conclusion: In patients with Pulmonary aplasia in CXR, we should rullout broncho-esophageal fistula after Pulmonary CTscan with esophagography.

Introduction: Pulmonary embolism (PE) affects 0.5-1 per 1000 people in the general population each year, and is one of the most common preventable causes of death among hospitalized patients. Unfortunately the diagnosis is missed more often than it is made, because PE often causes only vague and nonspecific symptoms. The clinical diagnosis of PE is unreliable and must be confirmed objectively with ventilation perfusion scanning or CT-angiography.Cardiogenic shock or systolic hypotension (BP<90mmHg), and presence of rightventricular dysfunction or two principal criteria which govern the severity of PE.Chronic thromboembolic disease develops in only 0.5% of patients with a clinically recognized acute P.E. Most patients diagnosed with chronic PE have no antecedent history of acute emboli.We frequently detect Pulmonary hypertension even when less than 50% of the vascular bed is occluded by thrombus. This process may lead to an inoperable situation.The most common symptom associated with thromboembolic Pulmonary, hypertension, as other of Pulmonary hypertension, is exertional dyspnea syncope or presyncope is another common symptom in Pulmonary hypertension. Currently, Pulmonary angiography remains the gold standard for diagnosis of chronic thromboembolic Pulmonary hypertension. Patients over age 40 undergo coronary arteriography and other cardiac investigations as necessary.Chronic anticoagulation represents the main stay of medical regimen because of the bronchial circulation, Pulmonary embolism, seldom results in tissue necrosis.Pulmonary endarterectomy appears to be permanently curative.