CTICasesUndiagnosed Double Aortic Arch in an Elderly Adult
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Imaging findings
Chest radiograph shows an abnormal mediastinum with an azygos fissure and abnormal right paratracheal stripe. CT demonstrates a double aortic arch with two arches of roughly equal size, symmetric and separate origins of the four neck vessels, and the aorta descending on the left.
Key takeaways
Double aortic arch is a congenital anomaly usually presenting in childhood with stridor or feeding problems. However, it can remain undiagnosed into adulthood if the vascular ring is sufficiently loose. The "four vessel sign" on CT with separate origins is characteristic.
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