Dysphagia lusoria - aberrant right subclavian artery

Case contributed by Dr Andrew Ho

Presentation

Ongoing dysphagia.

Patient Data

Age: 60 years
Gender: Female

Esophagram shows barium contrast being held up by an extrinsic mass on the esophagus near the level of the aortic arch, highly suggestive of an aberrant right subclavian artery.

An aberrant right subclavian artery, arising from the distal aortic arch, crosses behind the esophagus and causes significant mass effect on the posterolateral esophageal wall causing the patient's dysphagia.

Note the brachiocephalic artery is not present and the first branch vessel arising from the aortic arch is the right common carotid artery.

Case Discussion

Aberrant subclavian artery is the last branch of 4-branch vessel aortic arch.  This is the most common congenital anomaly of the aortic arch.

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