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Age: 3

Sex: Female

Indication: Choking, history of esophageal atresia repair

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Case #39


Findings

  • Patulous, gas-filled esophagus with gradual tapering distally near the gastroesophageal junction. Lobular soft tissue density in the mid esophagus
  • No focal airspace opacification, pleural effusion, or pneumothorax
  • Borderline enlargement of the cardiothymic silhouette
  • Right aortic arch


Diagnosis

  • Impacted food bolus
  • Right aortic arch

Sample Report

Patulous, gas-filled esophagus with gradual tapering distally near the gastroesophageal junction. Lobular soft tissue density in the mid esophagus is concerning for impacted food bolus.

No focal airspace opacification, pleural effusion, or pneumothorax.

Borderline enlargement of the cardiothymic silhouette.

Right aortic arch.


Discussion

  • Patients with esophageal atresia commonly have long-term problems with esophageal motility after surgical repair
  • Remember that a right aortic arch can be associated with congenital heart disease (particularly Tetralogy of Fallot and truncus arteriosus)


Images

Red line: impression on the right aspect of the trachea from a right aortic arch. Blue lines indicate the diameter of a patulous, gas-filled esophagus. Red arrows: impacted food bolus.

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