Aberrant right subclavian artery
Severe dysphagia leading to feeding difficulties malnutrition and anaemia. Investigated with endoscopy, barium swallows with no abnormality identified. CT was ordered as patient presented with severe shortness of breath. As underlying malignancy was suspected CTPA was planned to exclude secondary PE.
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Aberrant right subclavian artery is evident posterior to the esophagus.
Aberrant right subclavian arteries are a commonly seen normal variant of the aortic arch. It may rarely cause difficulties with swallowing, called dysphagia lusoria.
In this case, the dysphagia was severe and lead to significant malnutrition. Identification of this normal variant was crucial for the explanation of patient's symptoms and planning of further management.
No other underlying abnormality, including occult malignancy, was identified.