Presentation
Began regurgitating when weaned onto solid food. Less active and lower weight than littermates.
Patient Data
On the lateral radiograph, the trachea is ventrally deviated cranial to the heart. There is gas in the cervical and proximal thoracic esophagus. On the v/d projection, the cranial mediastinum is widened, with increased soft tissue opacity and a gas-filled esophagus. The trachea is deviated sharply to the left at the level of the third rib. The remainder of the cardiopulmonary structures appear normal.
There is poor peritoneal detail consistent with the young age of the animal. The gastrointestinal tract contains some mineral opacity foreign material.
On the esophagram, the proximal esophagus is dilated. A bolus is static at the third intercostal space, with a small amount of barium passing distal to this site and into the stomach. The distal esophagus is normal.
Case Discussion
The location of the stricture is consistent with a congenital vascular ring anomaly causing extraluminal obstruction. A persistent right aortic arch and ligamentum arteriosum constricting the esophagus were identified at surgery.
The proximal esophageal dilation and deviation of the trachea are characteristic of a vascular ring anomaly, commonly a persistent right aortic arch. The abnormal vasculature forms a ring that entraps the trachea and esophagus between the heart and the aorta. The focal nature of the constriction causes the sharp left deviation of the trachea near the third intercostal space.
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