Barium Swallow and Computed Tomography Angiographic Diagnosis of Descending Thoracic Aortic Diverticulum in Right-sided Aortic Arch: Rare Cause of Dysphagia

ABSTRACT: Descending thoracic aortic diverticulum associated with right-sided aortic arch is a very rare etiology of dysphagia. This report presents the case of a 42-year-old male who came with worsening dysphagia to solids, where barium swallow revealed smooth posterior esophageal indentation, and computed tomography (CT) angiography demonstrated Edwards Type I mirror-image branching with a descending aortic diverticulum indenting the esophagus. This case served to emphasise the value of vascular anomalies being considered as a reason for unexplained dysphagia. Barium swallow and CT angiography gave complementary functional and anatomic assessment, facilitating accurate diagnosis and management planning of unusual aortic diverticula.