Azygo-esophageal recess deviation

Last revised by Joshua Yap on 27 Apr 2023

Deviation of the azygo-esophageal recess can be normal or pathological.

The azygo-esophageal recess is formed by the interface between the right lung and the mediastinal reflection of the azygos vein and esophagus. The line has a variable appearance 1:

  • in its upper third, it deviates to the right, where it may either be straight or concave relative to the right lung; in children and young adults, it can be convex relative to the right lung

  • in its middle third, it is usually straight, but may be slightly convex relative to the right lung near the right pulmonary veins

  • in its lower third, it is usually straight

The azygo-esophageal recess may be deviated by conditions that affect the middle or posterior mediastinal compartments including 2:

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