Online First
Clinical Images  |   October 2020
Dysphagia Lusoria
Author Notes
  • From Advocate Lutheran General Hospital in Park Ridge, Illinois.  
  • Financial Disclosures: None reported.  
  • Support: None reported.  
  •  *Address correspondence to: Ryan Hoff, DO, Advocate Lutheran General Hospital, 1775 Dempster St, Park Ridge, IL, 60068-1176. Email: ryan.hoff@advocatehealth.com
     
Article Information
Ophthalmology and Otolaryngology
Clinical Images   |   October 2020
Dysphagia Lusoria
The Journal of the American Osteopathic Association Published Online First on October 12, 2020. doi:https://doi.org/10.7556/jaoa.2020.139
The Journal of the American Osteopathic Association Published Online First on October 12, 2020. doi:https://doi.org/10.7556/jaoa.2020.139
A 68-year-old man presented to the emergency room with decreased appetite and regurgitation of food for several months. The patient's history was notable for developmental delay, well-controlled gastroesophageal reflux disease without esophagitis, and imperforate anus status post colostomy. A fluoroscopic swallow evaluation showed no aspiration. A barium esophagram showed a calcified aortic arch trapping the proximal esophagus anteriorly and posteriorly, resulting in the bayonet sign (image A).1 Computed tomography angiography of the chest confirmed compression of the esophagus by the anomalous aortic arch, marked by increased tortuosity and a right circumflex cervical aortic arch causing esophageal compression high in the mediastinum (image B). The patient was treated with dietary modifications and had satisfactory results. 

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