What is the Cause of this Dysphagia?
A 60-year-old woman visited the hospital with nonprogressive mild esophageal dysphagia (without oropharyngeal transfer difficulties for solids) for 10 years. Her clinical examination and screening blood tests were normal.
She had no previous medical problems except for carrying the hepatitis B virus. She underwent an upper gastrointestinal endoscopy, which revealed external compression and extrinsic arterial pulsations of the upper esophagus posteriorly (Figure A).
A computed tomography scan showed a right-sided aortic arch and compression of the posterior wall of the upper part of the esophagus (Figures B and C).
The volume-rendered reconstruction image showed anomalous origin of left common carotid artery from the ascending aorta and left subclavian artery originating from the diverticulum (Figures D and E).