Aortic nipple

Last revised by Daniel J Bell on 28 Jun 2021

An aortic nipple is seen in about 10% of PA chest x-rays on the lateral surface of the aortic arch/aortic knob. It represents the left superior intercostal vein.

When prominent, superior vena cava obstruction should be considered as the left superior intercostal vein serves as a collateral pathway.

Very rarely, an absent azygos vein will be the cause of an aortic nipple 3.

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Cases and figures

  • Case 1
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  • Case 2: annotated chest radiograph
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  • Case 2: 3D CT reconstruction
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