“…Perforations of the esophagus into an aberrant RRSA by a for eign body is quoted by Merchant et al 11977], A specific diagnostic sign for a RRSA is the indentation of the esophagus produced by the vessel [Kommerell, 1936]. The defect may be seen pulsating [Felson et al, 1950). An RRSA was also found to be a cause of cerebral circulatory failure [Skiora et al, 1978;Wackenheim and Kleinclaus, 1979], Surgical interventions are often per formed on an RRSA which is producing symptoms [ Cross and Ware, 1946;Gross and Neahauser, 1951;Blalock, 1948;Vidne et al, 1972;Lemire et al, 1977;Weinberger et al, 1977;Jung et al, 1978;Lam et al.…”