Pediatric Left Aortic Arch With Aberrant Right Subclavian Artery

  • Etiology: Congenital
  • Imaging UpperGI: Posterior indentation on the esophagus
  • DDX:
  • Complications:
  • Treatment:
  • Clinical: Usually asymptomatic but occasionally can have dysphagia lusora

Radiology Cases of Left Aortic Arch With Aberrant Right Subclavian Artery

UGI of left aortic arch with aberrant right subclavian artery
AP (left) and lateral (right) images from an upper GI exam shows a left sided aortic arch and a posterior indentation on the esophagus.
UGI and CT of left aortic arch with aberrant right subclavian artery
Lateral image from an UGI exam (above left) shows a persistent posterior indentation on the proximal esophagus. Sagittal CT with contrast of the chest (above right) shows an aberrant artery located posterior to the esophagus and anterior to a vertebral body. Axial CT (below) shows the right subclavian artery to be arising aberrantly from the aorta and coursing anterior to the vertebral body and posterior to the aerated trachea and collapsed esophagus.
UGI and CT of left aortic arch with aberrant right subclavian artery
AP image from an upper GI exam (above left) shows a left sided aortic arch and an indentation running at an angle from left to right across the upper esophagus. Lateral image from an upper GI exam (above right) shows a posterior indentation across the upper esophagus. Axial CT with contrast of the chest (below) shows an aberrant artery coursing anterior to the vertebral body and posterior to the aerated trachea and collapsed esophagus.

Radiology Cases of Left Aortic Arch With Aberrant Right Subclavian Artery and Mesenteroaxial Gastric Volvulus

Upper GI of pediatric mesenteroaxial gastric volvulus
Lateral image from an upper GI exam (left) shows a fixed indentation on the posterior aspect of the mid-esophagus. AP images from the upper GI exam (right) show the stomach appears to be upside-down with the antrum and pylorus superior to the fundus and proximal body of the stomach. Note how the pylorus of the stomach is located superiorly to the gastroesophageal junction.