There was no gross spillage of content from the site of the incision. The patient was stable and local conditions allowed the esophagotomy to be closed buy Pitavastatin primarily. A close suction drain was placed after a thorough irrigation. The patient was transferred to the intensive care unit for further treatment and stabilization. The post operative curse was complicated with a lobar pneumonia from which she never recovered. The patient expired on post operative day 14. Discussion In normal embryologic development, the subclavian arteries originate from the seventh intersegment arteries. The distal segment of the right dorsal aorta degenerates, and the right seventh intersegment artery becomes confluent with the right fourth arch. In the

anomaly of aberrant right subclavian artery, abnormal development results from degeneration of the entire right fourth arch. The right seventh intersegment artery persists in its attachment to the distal descending aorta [4]. In 80% of cases, it crosses between the LCZ696 cost esophagus and the vertebral column, in 15% of cases it runs between the esophagus and the trachea, and in

5% of cases it passes anterior to both this website the trachea and esophagus [5]. Aberrant right subclavian artery in the adult patient, usually present with dysphagia. Symptoms are primarily for solid food and are associated with regurgitation, postprandial bloating or chest pain [5]. We could not find reports of ARSA resulting in esophageal foreign body impaction in adults. The esophagus has 3 areas of narrowing where foreign bodies are most likely to become entrapped: the upper

esophageal sphincter (UES), which consists of the cricopharyngeus muscle; the crossover of the aorta; and the lower esophageal sphincter (LES). Ingestion of foreign bodies are much more common in children than in adult and considering the fact that most of the patient harboring an aberrant right subclavian artery are asymptomatic through their life time [5], the association between these two entities could be incidental. In adults Protein tyrosine phosphatase the incidence of foreign body ingestion is rare. It is reasonable to assume that the foreign body in our case was trusted into the esophagus at this exact level because of a relative narrowing caused by the back compression of the right aberrant subclavian artery on the esophagus. Supporting this assumption is the CT scan findings of our patient revealing the foreign body impacted just at the level of the vascular anomaly. Conclusion An aberrant right subclavian artery should be suggested when foreign body in the proximal esophagus is encountered even in the previously asymptomatic patient. Patient consent Written Informed consent was obtained by the patient’s daughter for publication of this case report and any accompanying images. A copy of the written consent is available for review by the editor in chief of this journal. References 1. Asherson N: David Bayford, His syndrome and sign of dysphagia lusoria.