A rare cause of dysphagia

Description

A middle-aged woman presented with dysphagia and globus sensation. Upper endoscopy was unremarkable and barium swallow revealed persistent, smooth indentation of the posterior aspect of the upper thoracic oesophagus at T4 level, suggesting external compression (figure 1). Subsequent CT thorax demonstrated an aberrant right subclavian artery compressing the posterior oesophagus (figure 2). A diagnosis of dysphagia lusoria was made.

Figure 1

Coned lateral view of the barium swallow showed an indentation over the posterior wall of the upper thoracic oesophagus at T4 vertebral level.

Figure 2

Contrast-enhanced CT of the thorax showed an aberrant origin of the right subclavian artery from the aortic arch distal to the left subclavian origin (red arrow), with compression to the posterior aspect of the oesophagus (green arrow).

The aberrant right subclavian artery is present in...

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