What is the most likely cause of a vessel indenting the right anterolateral aspect of the trachea in a child with stridor, as shown on Magnetic Resonance Imaging (MRI)?

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Differential Diagnosis for Vessel Indenting the Right Anterolateral Aspect of the Trachea

  • Single most likely diagnosis
    • Aberrant right subclavian artery: This is the most common congenital anomaly of the aortic arch and can cause compression of the trachea or esophagus, leading to symptoms such as stridor. The aberrant right subclavian artery typically arises from the left side of the aortic arch and crosses over to the right side, which can indent the right anterolateral aspect of the trachea.
  • Other Likely diagnoses
    • Double aortic arch: Although less common than an aberrant right subclavian artery, a double aortic arch can also cause tracheal compression. In this condition, both the right and left aortic arches are present and can encircle the trachea, leading to symptoms such as stridor.
    • Aberrant innominate artery: An aberrant innominate artery can also cause tracheal compression, although it is less common than an aberrant right subclavian artery. The aberrant innominate artery can arise from a more distal or anomalous location, which can lead to compression of the trachea.
  • Do Not Miss diagnoses
    • Anomalous origin of the left coronary artery: Although rare, an anomalous origin of the left coronary artery can cause compression of the trachea or other mediastinal structures. This condition can be life-threatening if not diagnosed and treated promptly.
    • Pulmonary artery sling: A pulmonary artery sling is a rare condition where the left pulmonary artery arises from the right pulmonary artery and encircles the trachea, causing compression. This condition can be life-threatening if not diagnosed and treated promptly.
  • Rare diagnoses
    • Other vascular anomalies: There are several other rare vascular anomalies that can cause tracheal compression, such as an anomalous origin of the right subclavian artery or an aberrant left vertebral artery. These conditions are rare and often require specialized imaging and diagnosis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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