scholarly journals Co-Occurrence of Rarest Type of Dysphagia Lusoria (Type N-1) and Eosinophilic Esophagitis in a Cognitively Disabled Individual

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Kishore Kumar ◽  
Jasbir Makker ◽  
Hassan Tariq ◽  
Ariyo Ihimoyan ◽  
Chime Chukwunonso ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Eosinophilic Esophagitis ◽  
Previous History ◽  
Food Allergies ◽  
Aberrant Right Subclavian Artery ◽  
Food Impaction ◽  
Diagnostic Challenge ◽  
Dysphagia Lusoria ◽  
Extrinsic Compression ◽  
History Of

Dysphagia is an expressive symptom, described by an individual as “difficulty in swallowing.” Dysphagia due to esophageal compression from an aberrant right subclavian artery is rare, and it is termed as “dysphagia lusoria.” We present a rare case of co-occurrence of dysphagia lusoria with esophageal eosinophilia in a patient with cognitive disability which portends a case with diagnostic challenge and treatment dilemma. A 31-year-old man with intellectual disability, cerebral palsy, previous history of feeding difficulty, and esophageal food impaction presented with esophageal foreign body impaction. He has no known history of atopy and food allergies. There was no laboratory evidence of peripheral eosinophilia. The IgE-mediated allergic test was unremarkable. His prior presentation revealed a diagnosis of eosinophilic esophagitis. The imaging studies showed proximal esophageal dilatation with extrinsic compression at the level of the upper esophagus. The foreign bodies were removed successfully through the help of upper endoscopy. Subsequent evaluation revealed a rare type of dysphagia lusoria (type N-1) due to an aberrant left subclavian artery arising from the right-sided aortic arch. The patient’s family refused further management of artery lusoria. Prolonged stasis of secretions and food in the esophagus can also lead to increased esophageal eosinophils. In our case, it remains undetermined whether increased number of esophageal eosinophils resulted from primary eosinophilic esophagitis or due to prolonged food stasis from esophageal compression caused by an aberrant subclavian artery. However, food impaction right above the compression site makes dysphagia lusoria the likely etiology.

Aberrant right subclavian artery – a rare congenital anatomical variation causing dysphagia lusoria

VASA ◽  
2020 ◽  
pp. 1-4
Author(s):  
Foivos Irakleidis ◽  
Jonathon Kyriakides ◽  
Daryll Baker
Keyword(s):  
Subclavian Artery ◽  
Incidental Finding ◽  
Anatomical Variation ◽  
Later Life ◽  
Aberrant Right Subclavian Artery ◽  
Barium Swallow ◽  
Common Symptom ◽  
Dysphagia Lusoria ◽  
Anatomical Anomaly ◽  
History Of

Summary: An aberrant right subclavian artery (ARSA) is a rare anatomical variation of the aortic arch. Although an incidental finding and asymptomatic in the majority of individuals, an ARSA can cause troubling symptoms during both childhood and in later life. In adulthood, the most common symptom is dysphagia, where the condition is named dysphagia lusoria. In other rare cases it can cause shortness of breath, chronic cough and hoarseness of voice amongst others. We present a case of a 65-year-old female patient who was diagnosed with dysphagia lusoria following a barium swallow examination to investigate a 10-year history of dysphagia. She was further investigated with other imaging modalities to establish her diagnosis. The dysphagia was not progressive, nor did it result in malnutrition, and hence the patient was managed conservatively. There is currently no established guideline to classify the severity of symptoms or radiological findings of this anatomical anomaly. Our case reiterates the importance of such protocols, in order to be able to avoid the risks of an unnecessary surgical procedure, whilst being sure to prevent the undertreatment of affected individuals.

scholarly journals Case report: a step-wise management of concurrent presentation of congenital single lung and aberrant right subclavian artery in an infant girl

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Keon Young Park ◽  
Kevin C. Janek ◽  
Joshua L. Hermsen ◽  
Petros V. Anagnostopoulos ◽  
Hau D. Le
Keyword(s):  
Subclavian Artery ◽  
Tissue Expander ◽  
Rare Condition ◽  
Aberrant Right Subclavian Artery ◽  
Cross Sectional ◽  
Unique Challenge ◽  
Surgical Interventions ◽  
Tracheal Compression ◽  
Dysphagia Lusoria ◽  
Infant Girl

Abstract Introduction Congenital single lung (CSL) is a rare condition, and symptomatic patients often present with respiratory distress or recurrent respiratory infection due to mediastinal shift causing vascular or airway compression. Aberrant right subclavian artery (ARSA) is another rare congenital anomality that can lead to tracheal or esophageal compressions. There is only one other case of concurrent presentation of CSL and ARSA reported, which presented unique challenge in surgical management of our patient. Here we present a step-wise, multidisciplinary approach to manage symptomatic CSL and ARSA. Case presentation An infant girl with a prenatal diagnosis of CSL developed worsening stridor and several episodes of respiratory illnesses at 11 months old. Cross-sectional imaging and bronchoscopic evaluation showed moderate to severe distal tracheomalacia with anterior and posterior tracheal compression resulting from severe mediastinal rotation secondary to right-sided CSL. It was determined that her tracheal compression was mainly caused by her aortic arch wrapping around the trachea, with possible additional posterior compression of the esophagus by the ARSA. She first underwent intrathoracic tissue expander placement, which resulted in immediate improvement of tracheal compression. Two days later, she developed symptoms of dysphagia lusoria due to increased posterior compression of her esophagus by the ARSA. She underwent transposition of ARSA to the right common carotid with immediate resolution of dysphagia lusoria. As the patient grew, additional saline was added to the tissue expander due to recurrence in compressive symptoms. Conclusions Concurrent presentation of CSL and ARSA is extremely rare. Asymptomatic CSL and ARSA do not require surgical interventions. However, if symptomatic, it is crucial to involve a multidisciplinary team for surgical planning and to take a step-wise approach as we were able to recognize and address both tracheomalacia and dysphagia lusoria in our patient promptly.

scholarly journals Osteochondroma of the scapula associated with a subclavian artery pseudoaneurysm: Case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1882308
Author(s):  
Ana Oljaca ◽  
Daniela Hirzberger ◽  
Marko Bergovec ◽  
Kurt Tiesenhausen ◽  
Stephan H Koter ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Clinical Status ◽  
Previous History ◽  
Vascular Complications ◽  
Mechanical Compression ◽  
Vascular Surgeon ◽  
Artery Pseudoaneurysm ◽  
Dorsal Aspect ◽  
Multiple Exostoses ◽  
History Of

Osteochondromas rarely induce vascular complications by mechanical compression. We present the case of a subclavian artery pseudoaneursym caused by an osteochondroma of the scapula in a 67-year-old male. The diagnosis was based on a previous history of multiple exostoses, computed tomography and magnetic resonance imaging, as well as the local vascular clinical status of the lesion. Surgical treatment consisted of vascular and orthopaedic intervention. First, the vascular surgeon implanted a bypass of the subclavian artery from the ventral aspect, enabling the orthopaedic surgeon to resect the osteochondroma from the dorsal aspect. The patient recovered with full function. Vascular pseundoaneurysms should be taken into consideration in patients with osteochondromas, especially with a known history of multiple hereditary exostoses.

Hybrid Endovascular Treatment of Dysphagia Lusoria: Report of 2 Cases

2020 ◽  
Vol 54 (8) ◽  
pp. 747-751
Author(s):  
Abindra Sigdel ◽  
Erik J. Wayne ◽  
Amit J. Dwivedi
Keyword(s):  
Endovascular Treatment ◽  
Subclavian Artery ◽  
Symptom Relief ◽  
Aberrant Right Subclavian Artery ◽  
Endovascular Technique ◽  
Related Complication ◽  
Dysphagia Lusoria

Dysphagia Lusoria is a condition when aberrant right subclavian artery (ARSA) causes esophageal compression. We report 2 cases of Dysphagia Lusoria treated by hybrid endovascular technique which included subclavian to carotid transposition and embolization of origin of ARSA. By using this technique, we avoided the need for thoracotomy. Both patients had complete symptom relief without any surgery related complication.

scholarly journals Dysphagia Lusoria: Aberrant Right Subclavian Artery Transposition to Carotid Artery

2015 ◽  
Vol 62 (3) ◽  
pp. 834
Author(s):  
Raghu L. Motaganahalli ◽  
Victor Njoku ◽  
Alok Gupta ◽  
Anjan Talukdar ◽  
Adam Gracon ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Dysphagia Lusoria

Endoscopy and the Aberrant Right Subclavian Artery

2007 ◽  
Vol 73 (12) ◽  
pp. 1259-1261 ◽  
Author(s):  
Michael D. Kelly
Keyword(s):  
Ct Scan ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Diagnostic Endoscopy ◽  
Dysphagia Lusoria

The aberrant right subclavian artery is present in 0.4 per cent of the population. It is usually asymptomatic and only rarely causes symptomatic esophageal compression, a condition known as dysphagia lusoria. It was diagnosed in one of 920 patients undergoing diagnostic endoscopy (223 for dysphagia) and characterized by CT scan. It is important for clinicians to be aware of this condition and that the artery may be visible at endoscopy.

scholarly journals Stent erosion after treatment of coarctation of right-sided aorta and successful surgical management

2019 ◽  
Vol 57 (5) ◽  
pp. 1007-1008
Author(s):  
Andreas Rukosujew ◽  
Raluca Weber ◽  
Bernd Kasprzak ◽  
Angelo Maria Dell’Aquila
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Septal Defect ◽  
Artery Bypass ◽  
Previous History ◽  
Second Step ◽  
Descending Aorta ◽  
History Of ◽  
Aorta Replacement ◽  
The Right

Abstract We present a case of surgical treatment of a pseudoaneurysm of the right-sided aortic arch after stent implantation for primary coarctation in a 36-year-old woman with a previous history of ventricle septal defect closure in early childhood. As a first step, she underwent a left carotid to subclavian artery bypass for an aberrant left subclavian artery and as a second step a ‘beating heart’ aortic arch and descending aorta replacement via resternotomy. The postoperative course was uneventful.

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