Dysphagia due to Esophageal Compression by Bronchial Artery Hypertrophy

Recurrent respiratory tract infections and dysphagia after the first years of life are rarely caused by vascular compression of the esophagus. We experienced a case of dysphagia and frequent vomiting resulted from esophageal compression by bronchial artery hypertrophy, which might had been aggravated by recurrent aspiration pneumonia caused by underlying swallowing difficulty. The patient initially had significant motor delay and swallowing difficulty. Videofluoroscopic swallowing studies demonstrated deglutition abnormalities and aspiration. In addition, significant amount of swallowed food was regurgitated through esophagus. On barium esophagography and angiography, posterior indentation of the esophagus without proximal dilatation and bronchial artery hypertrophy were noted without congenital heart disease. Pulmonary trunk and its branches showed normal appearance. Therefore, we considered that bronchial artery hypertrophy attributed to pulmonary artery fibrosis due to recurrent aspiration pneumonia may cause esophageal compression, which in turn contribute to dysphagia, frequent vomiting and recurrent aspiration pneumonia.