Presentation
Chronic dysphagia. New presentation with cough and fever.
Patient Data
The right subclavian artery originates directly from the aortic arch and has a retro-esophageal course with dilation at the beginning of its path, (Kommerell diverticulum) and distal aneurysm.
Case Discussion
An aberrant right subclavian artery (ARSA) is an uncommon congenital anomaly where the right subclavian artery arises distal to the left subclavian artery instead of branching from the brachiocephalic trunk. It takes an abnormal retro-esophageal path to reach the right arm, and this portion is often dilated, known as Kommerell's diverticulum. This dilatation can exacerbate esophageal compression and dysphagia. The aberrant artery often demonstrates accelerated atherosclerosis, as in this case, and there is aneurymal dilatation just distal to the diverticulum.
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