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Dysphagia Lusoria


Presentation

  • Symptoms, when present, occur at the two extremes of life. Owing to the more flexible and compressible nature of the trachea, children usually present with respiratory symptoms, in contrast to adults, who more often present with dysphagia.[ncbi.nlm.nih.gov]
  • Author notes † Presented as a poster presentation at CT CON 2010, Annual Conference of the Indian Association of Cardiothoracic and Vascular Surgeons, Chennai, India, 18 February 2010. The Author 2012.[dx.doi.org]
  • Only one patient presented with an aneurysmal rupture. In infants, respiratory symptoms are the predominant mode of presentation.[dx.doi.org]
  • The presentation, evaluation, pathophysiology, and treatment of this condition are discussed.[ncbi.nlm.nih.gov]
Asymptomatic
  • Six months postoperatively the patient was asymptomatic and had gained weight. There was no radiologic evidence of esophageal compression.[ncbi.nlm.nih.gov]
  • The various embryologic anomalies of the arterial brachial arch system often remain unrecognised and asymptomatic, but in 30%-40% of cases can result in tracheo-oesophageal symptoms, which in the majority of cases manifest as dysphagia.[ncbi.nlm.nih.gov]
  • At 6 months follow-up she was totally asymptomatic. Figure 1. Figure 2. Figure 3. Right-sided aorta is present in 0.04% to 0.1% of the population, 50% of which are associated with an aberrant left subclavian artery.[revespcardiol.org]
  • Most patients with an aberrant subclavian artery are asymptomatic. Children may present with recurrent pulmonary infections or stridor, in contrast to adults, who more often present with dysphagia.[nejm.org]
  • Dysphagia lusoria is often asymptomatic, but around 30% of patients may complain of dysphagia, dyspnoea and retrosternal pain.[casereports.bmj.com]
Multiple Congenital Anomalies
  • congenital anomalies of the aortic arch. ( 16337801 ) Panebianco V....Passariello R. 2006 50 Dysphagia lusoria assessed by 3-dimensional CT. ( 16860081 ) Keum B....Hyun J.H. 2006[malacards.org]
  • Dysphagia lusoria in combination with multiple congenital anomalies of the aortic arch. Eur J Cardiothor Surg 2006 ; 29 : 105. 9 Anomalous right subclavian aneurysm, report of 3 cases with a review of the literature.[dx.doi.org]
Weight Gain
  • Endoluminal grafts have also been reported especially in presence of aneurysm. [11] Our patient was managed conservatively with dietary readjustments and showed improvement with significant weight gain in 6 months.[slideshare.net]
Lymphadenopathy
  • No mediastinal or hilar lymphadenopathy. The heart is enlarged. There isatelectasis in both lower and the right middle lobes and smooth fatty pleural thickening at the left lung base.[slideshare.net]
Regurgitation
  • The patient had no complaints of dysphagia or regurgitation of food on discharge.[annalspc.com]
  • No odynophagia, nausea, vomiting, regurgitation, or weight loss were present, but the patient noted intermittent heartburn that improved with proton pump inhibitors.[dx.doi.org]
  • CASE 1 A 35-years-old female presented with dysphagia of many years duration.Dysphagia was worse with solids .She had no symptoms suggestive of regurgitation,early satiety or weight loss.[ijri.org]
Nausea
  • These patients are selected from the cases who were admitted due to their gastrointestinal symptoms, such as dysphagia, epigastric pain, chronic nausea, vomiting, etc. The mean age of patients was 40 /- 25 years (range 15-65).[ncbi.nlm.nih.gov]
  • Description A 36-year-old African–American woman with medical history of systemic lupus erythematosus, lupus nephritis, protein S deficiency and recurrent deep venous thrombosis presented to outpatient clinic complaining of epigastric pain associated with nausea[casereports.bmj.com]
  • No odynophagia, nausea, vomiting, regurgitation, or weight loss were present, but the patient noted intermittent heartburn that improved with proton pump inhibitors.[dx.doi.org]
Epigastric Pain
  • These patients are selected from the cases who were admitted due to their gastrointestinal symptoms, such as dysphagia, epigastric pain, chronic nausea, vomiting, etc. The mean age of patients was 40 /- 25 years (range 15-65).[ncbi.nlm.nih.gov]
  • Dysphagia lusoria presenting as epigastric pain Hoda Daher 1 , Samer Al Hadidi 2 1 Internal Medicine , Hurley Medical Center , Flint , Michigan , USA 2 Department of Internal Medicine , Hurley Medical Center/Michigan State University , Flint , Michigan[casereports.bmj.com]
  • pain. ( 29212867 ) Daher H....Al Hadidi S. 2017 10 Dysphagia lusoria as a differential diagnosis in intermittent dysphagia. ( 27093895 ) Febrero B....Parrilla P. 2017 11 Dysphagia Lusoria with a supracardiac total anomalous pulmonary venous connection[malacards.org]
Thrombosis
  • […] salhadi1{at}hurleymc.com Statistics from Altmetric.com gastroenterology oesophagus Description A 36-year-old African–American woman with medical history of systemic lupus erythematosus, lupus nephritis, protein S deficiency and recurrent deep venous thrombosis[casereports.bmj.com]
  • Furthermore, this technique may necessitate the use of a prosthetic graft, which carries a risk of future graft infection or thrombosis.[icvts.oxfordjournals.org]
  • Isolated case reports about rare symptoms produced by aberrant right subclavian artery mention superior vena cava obstruction, gastrointestinal bleeding and distal embolisation secondary to thrombosis [6].[ijri.org]
Hand Deformity
  • This patient's congenital hand deformities illustrate the embryological origin of this vascular anomaly, which is the most common congenital aortic root abnormality and has a prevalence ranging from 0.5% to 1.8% in the general population. 1 Barium esophagram[ncbi.nlm.nih.gov]
Suggestibility
  • Recent observation of one patient suffering from dysphagia lusoria has suggested critical review of treatment of the symptomatic aberrant right subclavian artery.[ncbi.nlm.nih.gov]
  • A barium esophagogram showed a diagonal impression in the proximal esophagus, while at esophagogastroduodenoscopy there was an extrinsic pulsatile bulging area suggesting an extrinsic compression by an aberrant vessel.[ncbi.nlm.nih.gov]
  • […] congenital hand deformities illustrate the embryological origin of this vascular anomaly, which is the most common congenital aortic root abnormality and has a prevalence ranging from 0.5% to 1.8% in the general population. 1 Barium esophagram is often suggestive[ncbi.nlm.nih.gov]
  • An esophagogram was performed, patient was not collaborative, it was not possible to opacify esophagus in its whole extension, it was observed a defect of irregular fullness in its third superior suggesting esophageal neoplasm.[medigraphic.com]
  • Miscusi Summary Recent observation of one patient suffering from dysphagia lusoria has suggested critical review of treatment of the symptomatic aberrant right subclavian artery.[link.springer.com]
Drop Attacks
  • A 45-year-old laborer presented with a several year history of episodic bilateral blindness and a more recent onset of "drop attacks." Notably this patient had presented at the age of 18 months with difficulty breathing and eating since birth.[ncbi.nlm.nih.gov]

Workup

  • Workup revealed a right-sided aortic arch with a left ligamentum arteriosum. When he was first seen in our clinic, history and physical examination revealed claudication and diminished pulses in the left upper extremity.[ncbi.nlm.nih.gov]

Treatment

  • An aperistaltic zone located in the upper third of the esophagus was present in a young woman with dysphagia, who had undergone surgical treatment for dysphagia lusoria 3 months before.[ncbi.nlm.nih.gov]
  • We believe this is the preferred surgical treatment of dysphagia lusoria in the adult.[ncbi.nlm.nih.gov]
  • Treatment was surgical in all patients with good results.[ncbi.nlm.nih.gov]
  • We recommend a left thoracotomy with division of the ligamentum as treatment.[ncbi.nlm.nih.gov]
  • Recent observation of one patient suffering from dysphagia lusoria has suggested critical review of treatment of the symptomatic aberrant right subclavian artery.[ncbi.nlm.nih.gov]

Etiology

  • Export Citation: APA/MLA Format Download EndNote Download BibTex MeSH Terms Descriptor/Qualifier: Aged Aorta, Thoracic / abnormalities* Deglutition Disorders / congenital*, etiology, radiography Diagnostic Errors Esophageal Stenosis / diagnosis Female[biomedsearch.com]

Pathophysiology

  • The presentation, evaluation, pathophysiology, and treatment of this condition are discussed.[ncbi.nlm.nih.gov]

Prevention

  • To prevent possible ischemic complications, most surgeons favor revascularization of the distal subclavian artery. Thoracotomy has been the traditional approach for division or reimplantation of the aberrant right subclavian artery.[ncbi.nlm.nih.gov]
  • Prevent and plan for complications prior to a procedure thanks to a step-by-step approach to each procedure accompanied by relevant imaging studies.[books.google.com]
  • Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive[jamanetwork.com]
  • […] aberrant right subclavian artery with a bicarotid trunk was seen in 29% of the cases of this branch anomaly. [6] In the absence of an aneurysm, it was the bicarotid trunk that accounted for the symptoms rather than the retroesophageal artery alone, by preventing[annalspc.com]
  • For infants and young children with signs of airway and/or esophageal compression, surgery is the treatment of choice to prevent worsening of symptoms. 1. Janssen M,Baggen MGA,Veen HF et al.[ijri.org]

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