Right Subclavian Artery With Kommerell's Diverticulum: A Rare Cause of Dysphagia

Kommerell's diverticulum is an embryologic developmental anomaly of the aortic arch wherein a diverticulum arises from either the left or the right aortic arch. It results due to the persistence of the remnant of the fourth dorsal aortic arch. We present a case of a 66-year-old female presenting with complaints of throat pain and difficulty swallowing. A computed tomography (CT) scan of the neck with contrast revealed an incidental finding of an aberrant right subclavian artery with associated diverticula of Kommerell, measuring up to 1 cm, causing a mass effect on the esophagus and posterior trachea. A diagnosis of dysphagia lusoria was established, and an upper gastrointestinal (GI) series revealed narrowing of the esophagus from posterior extrinsic compression. The patient was discharged home for nutrition optimization with a percutaneous endoscopic gastrostomy (PEG) tube due to significant weight loss from the inability to swallow before proceeding with surgery to repair the aberrant right subclavian artery.