52 year-old male with no clinical history

 

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Doctor's Information

Name : Morteza
Family :Sanei Taheri
Affiliation : Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree: Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Mohyeddin Mohammadi

 

Case Section

Cardiovascular

 

Patient's Information

Gender : Male
Age : 52

 

Clinical Summary

52 year-old male with no clinical history

 

 

Imaging Findings

Axial CTA shows origin of the right subclavian artery distal to the left subclavian (fourth branch of the arch). It crosses behind the esophagus to reach the right arm.

 

Differential Diagnosis

aberrant right subclavian artery

 

Final Diagnosis

aberrant right subclavian artery.

 

Discussion (Related Text)

Aberrant right subclavian artery is the most common arch anomaly and is found in approximately 2% of individuals. It is rarely symptomatic. The right subclavian artery arises as a fourth branch of the arch and must cross the mediastinum to reach the right arm. It crosses behind the esophagus in 80% of cases, between the trachea and esophagus in 15%, and anterior to the trachea in 5% .A dilatation at the origin of the anomalous vessel is termed a diverticulum of Kommerell. If large, it may cause significant posterior impression on the esophagus and result in dysphagia. symptoms accur at the two extremes of life in pations with this anomaly.in children , tracheal obstruction or dysphagia can occur ,whereas in adults, aneurysms of the aberrant subclavian artery or a prominent diverticulum of kommerell can occur,resulting in dysphagia classically known as dysphagia lusoria.less common symptoms of the aberrant right subclavian artery include superior vena cava obstruction and gastrointestinal bleeding.there are isolated case reports of thrombosis with distal embolization in patients with aberrant right subclavian artery. The diagnosis can be confirmed with either CT or MR.

 

References

Haaga J:CT and MR imaging of the whole body, 5th ed. Philadelphia:Mosby, 2009

Brant, William E.; Helms, Clyde A.Fundamentals of Diagnostic Radiology, 3rd Edition

 

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