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Infant With Recurrent Vomiting and Poor Weight Gain Secondary to an Aberrant Subclavian Artery

John Dugas1, Amber Vozar1, Seth J Deskins2

  • 1Pediatrics, West Virginia University, Morgantown, USA.

Cureus
|May 4, 2023
PubMed

Insights

Failure to thrive (FTT) in infants can stem from various causes. This case shows how esophageal compression by an aberrant right subclavian artery (ARSA) led to poor weight gain and vomiting.

Area of Science:

  • Pediatric Gastroenterology
  • Congenital Cardiovascular Anomalies

Background:

  • Failure to thrive (FTT) describes inadequate weight gain in infants.
  • While often linked to poor caloric intake, FTT can result from complex underlying conditions.

Observation:

  • An infant presented with persistent large-volume emesis and failure to thrive.
  • The infant exhibited symptoms suggestive of an obstructive process in the upper gastrointestinal tract.

Findings:

  • Esophageal compression due to an aberrant right subclavian artery (ARSA) was identified as the cause.
  • This vascular anomaly led to significant feeding difficulties and subsequent undernutrition.

Implications:

  • Highlights the importance of considering vascular anomalies in diagnosing FTT with emesis.
  • Underscores the need for thorough diagnostic workups to identify rare etiologies of pediatric undernutrition.
  • Suggests that early diagnosis and management of ARSA can prevent severe FTT and its complications.

Keywords:
abnormal branching of the subclavian arteryemesisesophageal compressionfailure to thriveinpatient pediatrics

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