A 3 Years Old Girl with Dysphagia

We report the case of a three-year-old girl who complained from dysphagia and post-prandial vomiting since she was 6 months old. Several diagnostic work-ups were performed for her problem. Upper GI endoscopy was normal but barium swallow revealed an external pressure effect over upper part of the esophagus (figure 1) and the CT angiography of thoracic aorta showed that this external pressure effect was due to a vascular anomaly in the aberrant branching of subclavian artery in the right side directly from aortic arch transmitting from the posterior aspect of the esophagus (figure 2). So the patient underwent elective operation and thorough right posterolateral thoracotomy from 5th intercostal space, right subclavian artery was divided from its origin to aorta and end to side anastomosis was made to proximal part of right carotid artery. Site of previous origin on aorta also was closed. After 5 days the patient was discharged from the hospital with good condition without any complication.