Recurrent Respiratory Tract Infections and Dysphagia in a Child With an Aortic Vascular Ring

Wolfgang Pumberger, MD, Peter Voitl, MD, Hubert Göpfrich, MD


South Med J. 2002;95(2) 

In This Article

Abstract and Introduction


Recurrent respiratory tract infections and dysphagia after the first years of life are rarely caused by vascular rings, and only a high index of clinical suspicion helps to avoid diagnostic delay and inappropriate treatment. Diagnostic workup in a 2-year-old girl with acute foreign body impaction into the esophagus and frequent respiratory tract infections revealed right descending aortic arch with ligamentum arteriosum as the cause of extrinsic esophageal-tracheal compression. Dividing the ligament gave release to the encircled esophagus and trachea. Relief of symptoms was achieved immediately after surgery.


Vascular rings caused by anomalies of the aortic arch and its branches generally present with respiratory distress, dyspnea, stridor, and swallowing difficulties shortly after birth. Less commonly, vascular rings have been proved to be the cause of recurrent respiratory tract difficulties and dysphagia later in life, without symptoms in early infancy. Diagnosis becomes more difficult and may be delayed for years in infants with less specific symptoms. We describe a 2-year-old girl in whom diagnostic workup of a foreign body impaction in the esophagus and recurrent respiratory tract infections revealed tracheal compression and impression of the esophagus due to a right aortic arch and ligamentum arteriosum.