The presence of an asymptomatic aberrant right subclavian artery: A potential risk factor in esophageal surgery?

Bleeding of an aberrant right subclavian artery following transthoracic en bloc esophagectomy and intrathoracic gastric reconstruction is a rare but severe complication in esophageal surgery. Preoperative diagnosis can be achieved by computed tomography or magnetic resonance angiography (MRA). Various treatment options are available; thus, the treatment can be challenging and should be adjusted to the severity of the symptoms. Bleeding of an aberrant right subclavian artery can result from perioperative vascular injury or various postoperative complications. We report about a case of a patient with esophageal cancer and an asymptomatic, simultaneously existing aberrant right subclavian artery. The patient underwent a successful conventional Ivor-Lewis esophageal resection without any life-threatening bleeding. Early detection and intraoperative identification was of major importance for successful surgery.