Dysphagia Lusoria in Childhood: An Uncommon Cause of Swallowing Difficulty

Dysphagia lusoria is a rare cause of esophageal compression, typically resulting from an aberrant right subclavian artery (ARSA). ARSA is the most frequently occurring anomaly of the aortic arch. Although usually asymptomatic, most patients complain of dysphagia or respiratory symptoms. This case is of a nine-year-old boy with asthma and allergic rhinitis who presented with chronic epigastric pain, vomiting, and progressive dysphagia to solids. His growth parameters were normal but on the lower end of the body mass index (BMI) range. Esophagogastroduodenoscopy showed a pulsatile external compression in the proximal to mid-esophagus. A retro-esophageal ARSA arising distally from the aortic arch is identified on a CT angiography. A multidisciplinary team advised surgical repair, and the patient underwent division and re-implantation of the ARSA. The postoperative course was uneventful, with marked improvement in dysphagia and vomiting. Early recognition and evaluation of dysphagia in children help minimize complications, leading to better outcomes.