Investigation of choice for dysphagia lusoria is?
**Core Concept**
Dysphagia lusoria is a rare condition characterized by difficulty swallowing due to an aberrant right subclavian artery compressing the esophagus. This condition is a type of vascular esophageal compression.
**Why the Correct Answer is Right**
The investigation of choice for dysphagia lusoria is a **barium swallow** or **esophagram**. This imaging technique involves swallowing a barium sulfate solution, which is then visualized using X-rays. The barium outlines the esophagus and any compressive lesions, such as an aberrant right subclavian artery. The esophagram is particularly useful in diagnosing dysphagia lusoria because it can demonstrate the dynamic compression of the esophagus by the aberrant artery during swallowing.
**Why Each Wrong Option is Incorrect**
* **Option A:** Endoscopy is not the investigation of choice for dysphagia lusoria because it may not demonstrate the compressive effect of the aberrant artery, which is a key feature of this condition.
* **Option B:** CT angiography is not the primary investigation for dysphagia lusoria, although it may be used to confirm the presence of an aberrant right subclavian artery. A barium swallow is generally preferred for initial evaluation.
* **Option D:** Esophageal manometry is not relevant to the diagnosis of dysphagia lusoria, which is primarily a structural problem rather than a motility disorder.
**Clinical Pearl / High-Yield Fact**
Dysphagia lusoria is a rare but important diagnosis to consider in patients with unexplained difficulty swallowing, particularly those with a history of congenital vascular anomalies.
**Correct Answer: C. Barium swallow.**