Background: Tracheobronchomegaly (TBM) is a rare disease of unknown etiology. It is characterized by dilatation of the central airways, and recurrent chest infection. It is usually overlooked for sometime before final diagnosis can be reached, particularly, if the clinical presentation has been associated with other abnormal findings. Case Report:We present a case of TBM seen in a patient with bilateral giant emphysematous bullae and bilateral basal pneumonia. This was diagnosed accidentally by using high resolution computed tomogram of the chest, in a patient who presented with acute shortness of breath secondary to exacerbation of chronic obstructive pulmonary disease (COPD) that was misdiagnosed because of large bullae as a pneumothorax for which a chest tube was inserted. To the author knowledge and from extensive review of the literature, such combinations have not been previously reported. Conclusions: TBM is a rare disease, and to reach the diagnosis a high index of clinical suspicious is essential particularly in middle aged patients who present with repeated chest infection. HRCT scan of the chest is usually diagnostic especially if the chest radiographs are normal.

Keywords: Tracheobronchomegaly, Mounier-Kuhn syndrome, bulla, emphysema