- MedPix™ TF Case: 4842 - Quiz Mode :: ::

A 2.5 year old female with a history of asthma presents for fluoroscopic evaluation of an abnormality noted on PA and lateral chest radiographs obtained during an episode of wheezing.

Normal cardiopulmonary exam.

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PA and lateral chest radiographs show a right-sided aortic arch and descending aorta and are otherwise unremarkable.

The frontal fluoroscopic image obtained during a barium swallow shows absence of the normal left-sided esophageal impression (i.e., absence of a normal left-sided aortic arch) and an abnormal impression on the right side of the esophagus just superior to the normal impression of the mainstem bronchus; this finding is consistent with a right aortic arch.

A lateral fluoroscopic image shows an indentation on the posterior wall of the esophagus and a more subtle indentation on the anterior wall of the trachea at a level just below the esophageal impression; these findings are consistent with a right aortic arch and an aberrant left subclavian artery.

Please see the accompanying factoid.

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