Anatomy: Aberrant RSCA, Pulmonary Sling, Barium Swallow

Aberrant Subclavian Artery Origin

(RSCA crosses midline, posterior to esophagus)

Netter diagram

Pulmonary Sling: Origin of LPA from RPA

(LPA crosses midline anterior to esophagus, inbetween esophagus & trachea)

(Diagrams below are from Esophagography in Anomalies of Aortic Arch System. A.C. Klinkhamer. The Williams & Wilkins Company, Baltimore MD. 1996)

How to use the Table:

1. First, review plain CXR (PA view; High dose film) - Ascertain aortic arch sidedness & position of descending aorta in thorax.

2. Second, study Barium Swallow Study - Usually Frontal and Oblique views (Note: Lateral view is ideal for Pulmonary sling and Double aortic arch, but not useful in other anomalies)

Image source: Esophagography in anomalies of the aortic arch system. A.C. Klinkhamer. The Williams & Wilkins Company, Baltimore, MD. 1969. Copyright - Excerpta Medica Foundation.

Related link: Barium Swallow


Vitali said...

Hi Dr. Bala! I am digging your archive. Thank you for covering this topic. Is it possible to enlarge the last picture (Diagnoses of aberrant arteries in the superior mediastinum....)? Smth is wrong with the link.

Bala said...

Will work on this when I get back to Houston a couple of days.

Bala said...

I hope, problem with the last image is fixed now. Try it. Original image is very small. If you download the image and print, you may be able to read the words in it. Good luck.

Vitali said...

Wow! It works and very readable. Thank you so much, Dr. Bala!