Vascular ring

Case contributed by A.Prof Frank Gaillard
Barium

Barium swallow

Barium swallow demonstrates a concentric attenuation of the barium contrast in the superior mediastinum.

CT

CT chest with contrast

The patient was then scanned with dynamic contrast administration, with a oesophageal boogie in situ (to better delineate the oesophagus). 

CTA of the chest obtained with a boogie in oesophagus (trachea anterior to it not seen) demonstrates a mirror image aortic arch with aberrant left subclavian artery (order of vessel origin from the aortic arch: left CCA, right CCA, right subclavian, left subclavian) which passes behind the oesophagus creating an incomplete ring.

Case Discussion

Incomplete vascular ring, in this case caused by a right sided aortic arch with mirror anatomy and an aberrant left subclavian artery. The mirror anatomy is a marker for likely co-existing congenital heart disease (not sure of any such defects in this patient). 

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Case information

rID: 7459
Case created: 2nd Nov 2009
Last edited: 4th Dec 2015
Inclusion in quiz mode: Included

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