Presentation
Wheezing, stridor and vomiting. Request to exclude a vascular sling and/or gastro-esophageal reflux.
Patient Data
There are posterior and bilateral esophageal indentations suggesting a double aortic arch.
The water-soluble single contrast swallow was otherwise normal.
There was no gastro-esophageal reflux.
Features consistent with an incomplete double aortic arch with a suspected atretic or involuted distal right aortic arch. The right subclavian and right common carotid artery originates from the right arch and the left subclavian artery and left common carotid artery originates from the left arch. There is a left-sided descending thoracic aorta.
There is anterior and bilateral tracheal indentation and consequently a pyramidal tracheal contour just above the carina.
CT chest is otherwise normal.
Case Discussion
An example of an incomplete double aortic arch with a likely atretic /involuted distal right aortic arch.
There is a pyramidal (triangular) contour of the trachea just above the carina due to the bilateral anterior indentations of the double aortic arch. This represents the source of the stridor.
The bilateral and posterior esophageal indentations likely account for dysphagia and vomiting.
Case courtesy: Dr MN Patel and Dr DH Jogi.
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