An Aberrant Right Subclavian Artery Causing Severe Esophageal Compression: A Case Report

An aberrant right subclavian artery (ARSA), a congenital vascular anomaly, can cause significant esophageal compression, leading to a condition known as dysphagia lusoria (DL). We present the case of a 44-year-old man with progressively worsening dysphagia and odynophagia over the last six months, resulting in severe weight loss and dietary restrictions. Imaging techniques revealed esophageal stenosis caused by external compression from an ARSA arising from the posterior wall of the distal aortic arch, accompanied by a Kommerell's diverticulum. Computed tomography angiography confirmed the aberrant origin, retroesophageal course, and vascular anomaly. Although surgical intervention involving ligation and excision of the retroesophageal artery segment with a right carotid-subclavian bypass was recommended, the patient opted for conservative management. This case highlights the importance of advanced imaging techniques in diagnosing DL and guiding treatment decisions. Regular follow-up remains essential to monitor disease progression and manage potential complications.