A rare anatomical variant: Aberrant arterial supply of azygoesophageal recess originating from the celiac plexus

Abstract

The aberrant arteries of the lung are very rare abnormalities. It is included in the type 1 sequestration group when it is a single finding without other sequestration features. Sequestrations account for <1% of all lung malformations. Type 1 is the least common form in this group. In 75% of these cases, the aberrant artery (AA) originates from the thoracic aorta. AA originating from the celiac plexus is very rare. Moreover, even if it originates from an abdominal vascular, AA is extended left lower lobe of the lung or the right middle lobe. Our case is atypical with its azygoesophageal recess (AOR) localization. The AOR is a special region that forms the mediobasal segment of the right lung. After the pandemic, this region has been expressed as one of the areas where COVID-19 infection shows affinity. The reason for this condition has not been definitively clarified yet. Therefore, the anatomical details of this segment need to be more probed. Furthermore, the radiological multidetector computed tomography (MDCT) appearance of our case is in the differential diagnosis, with Scimitar syndrome and, as far as we know, this differential diagnosis detail has not been mentioned so far. MDCT plays an important role in the diagnosis and planning of definitive treatment by determining the origin and course of the AA. Definitive treatment may be surgery (lobectomy or segmentectomy) or endovascular. The case of a 62-year-old patient with a lung AA is presented accompanied by radiological and clinical findings.