Presentation
Dysphagia and vomiting during feeding. Request for a water-soluble swallow to exclude a vascular sling.
Patient Data
There is aspiration change with right-sided tracheal buckling.
The cardiomediastinal contour is normal.
The bowel gas pattern is non-specific.
There is a persistent and abnormal, extrinsic impression on the thoracic esophagus at approximately T3/ T4 vertebral level suggestive of an aberrant right subclavian artery.
The indentation is posterior on the lateral swallow and oblique on the frontal series.
The water-soluble swallow was otherwise normal.
Note: limited series uploaded.
Annotated images demonstrate the posterior impression on the thoracic esophagus on the lateral series.
There is an oblique indentation on the frontal series as depicted.
Case Discussion
The single contrast water-soluble swallow suggested a likely aberrant right subclavian artery and consequent dysphagia lusoria in this infant.
The patient was referred for a cardiology assessment and an elective CT chest and aortogram is planned to confirm the water-soluble swallow findings.
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