Presentation
Frequently, an aortic out pouching, or Kommerell diverticulum (KD) is present at the ARSA aortic origin. Patients may present with “dysphagia lusoria” if the ARSA and KD compresses the esophagus posteriorly. [symposium.scvs.org]
At the patient’s 1-month follow-up appointment, she reported full resolution of her presenting symptoms. [jamanetwork.com]
In this article, we report the case of a 68-year-old woman who presented with shortness of breath. Respiratory function tests showed a slightly obstructive physiology. [ncbi.nlm.nih.gov]
Vascular ring with a Kommerell's diverticulum: Neonatal presentation with oesophageal symptoms. Indian J Med Res 2014;140:152-3 How to cite this URL: Bhat VS, Raj V. [ijmr.org.in]
Immune System
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Mediastinal Lymphadenopathy
Lung cancer is seen involving the left inferior lobe (lung window not shown), with associated mediastinal lymphadenopathy. Accessorily, a small hiatal herniation is seen. [radiopaedia.org]
Entire Body System
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Lymphadenopathy
Lung cancer is seen involving the left inferior lobe (lung window not shown), with associated mediastinal lymphadenopathy. Accessorily, a small hiatal herniation is seen. [radiopaedia.org]
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Collapse
If a complete vascular ring is present, airway obstruction and collapse may occur with induction of anesthesia, and require positive pressure ventilation and attempts to bypass the site of obstruction by an endotracheal tube (ETT) or even a rigid bronchoscope [journals.lww.com]
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Weight Gain
Follow-up at one month revealed resolution of dysphagia, weight gain and symmetric radial pulses. A PUBMED literature review of 33 cases performed from 1998-2012 reveals good early and mid-term results using endovascular and hybrid procedures. [symposium.scvs.org]
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Burning Pain
Case report Male, 65-year-old patient who referred having regurgitation (reflux) and retrosternal burning pain in the middle of the night. [scielo.br]
Respiratoric
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Respiratory Distress
The most common presentation was dysphagia, with respiratory distress and stridor only in the smaller children. [journals.lww.com]
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Sore Throat
Case Report A 68-year-old female with history of hypertension (HTN), hyperlipidemia, diabetes mellitus (DM) presented to the emergency department with chief complaints of chest pain and sore throat of four days duration. [ijcasereportsandimages.com]
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Rales
Chest auscultation was normal with no rales and no vascular or precordial murmur. Chest radiography identified a right aortic arch with mild tracheal deviation to the left and clear lung fields (Fig. 1). [journals.lww.com]
Gastrointestinal
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Overeating
Results: We identified 115 patients with KD age 0-86.7 years (median 34), including 64 over age 20. Arch side was right in 73 (63%), and left in 42 (37%). An incidental diagnosis of KD was made in 52 (45%), including 44 (69%) over age 20. [onlinejacc.org]
Presents the contributions of 70% new authors, from all over the world, in a consistent format to make referencing global perspectives quick and easy. [books.google.com]
We describe our experience with the management of this entity over a 15-year period. METHODS: Twenty-two patients underwent repair of aberrant subclavian arteries and associated Kommerell diverticulum. [ncbi.nlm.nih.gov]
Here, a bulge appears at the base of the subclavian artery near the trachea; this bulge is left over from a vessel that was present during an early stage of fetal development. [fhmedicalgroup.com]
Subsequently, a right third intercostal thoracotomy provided adequate exposure for repairing the aortic aneurysm and over-sewing the aneurysmal origin of the subclavian artery. [omicsonline.org]
Skin
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Flushing
In seven patients the diverticulum was resected flush with the aorta, and in one a Gore-Tex patch (polytetrafluoroethylene, W.L. [academic.oup.com]
Neurologic
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Aphasia
On admission, physical and neurological examination showed no abnormality except for the high systolic blood pressure (160 mmHg) and aphasia. Laboratory tests, including autoimmune markers and vasculitis serology, were normal. [synapse.koreamed.org]
Workup
Subsequent workup consisted of chest X ray, barium esophagram and a computed tomography (CT) scan of the neck. Chest X-ray showed prominent right aortic arch and slight deviation of trachea to left side (Figure 1) (Figure 2). [ijcasereportsandimages.com]
QT, RR, ST Intervals
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ST Elevation
The differential diagnosis considered were non-ST elevation myocardial infarction (NSTEMI), Streptococcal pharyngitis, right aortic arch with ALSA demonstrating a diverticulum of Kommerell with a diameter of 2.5 cm, and neoplasm of carotid body. [ijcasereportsandimages.com]
Blocks
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Right Bundle Branch Block
Electrocardiogram showed normal sinus rhythm with right bundle branch block. Brain magnetic resonance imaging with angiogram showed no evidence of cerebral infarction but bilateral internal carotid artery (ICA) stenosis. [synapse.koreamed.org]
T Wave
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T Wave Inversion
Initial electrocardiogram (EKG) in the emergency department showed straightening of and biphasic T waves in anterior leads (V1, V3, V4, and V5) and T wave inversions on repeat EKG. Patient was admitted to the hospital for further management. [ijcasereportsandimages.com]
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Biphasic T Wave
Initial electrocardiogram (EKG) in the emergency department showed straightening of and biphasic T waves in anterior leads (V1, V3, V4, and V5) and T wave inversions on repeat EKG. Patient was admitted to the hospital for further management. [ijcasereportsandimages.com]
Treatment
Surgical treatment for Kommerell’s diverticulum. J Thorac Cardiovasc Surg. 2006 ; 131 : 574–578. Crossref Medline Google Scholar 3 Kouchoukos NT, Masetti P. [circimaging.ahajournals.org]
Cina and Colls [ 7 ] recommended surgical treatment for aneurysms 3 cm or greater and in Ota experience [ 9 ] your primary indication was that the diameter of aneurysm was more than 50 mm. [cardiothoracicsurgery.biomedcentral.com]
Standard surgical treatment has not been established being a rare entity. Treatment is surgical resection of the diverticulum regardless of the size because of risk of rupture (19%) which is associated with high mortality [8]. [ijcasereportsandimages.com]
Surgical treatment is recommended to avoid the possibility of rupture and endovascular treatment has also become an option [ 1, 2 ]. [omicsonline.org]
Prognosis
Treatment and prognosis Given the rarity of this condition, there is no established management guideline. [radiopaedia.org]
Etiology
A possible etiology of the subclavian artery's anomalous origin would be an abnormality in regression of the fourth primitive aortic arch during embryonic development. [ncbi.nlm.nih.gov]
In addition to these etiologies, the possibility of incidentally observed Kommerell's diverticulum and persistent left side superior vena cava (PLSVC) should be included in the differential diagnosis. [synapse.koreamed.org]
Dysphagia of unclear etiology ( dysphagia lusoria) is the most common presenting symptom of an enlarged anomalous subclavian artery and a Kommerell’s diverticulum (2). [journals.lww.com]
Epidemiology
Epidemiological and demographic characteristics The frequency of ARSA varies throughout the world. [intechopen.com]
Pathophysiology
[…] the proximal descending aorta, the so-called Diverticulum of Kommerell (which was named for the German Radiologist, Burkhard Friedrich Kommerell (1901–1990), who discovered it in 1936). [5] [6] It is alternatively known as a lusorian artery. [1] [3] Pathophysiology [en.wikipedia.org]
Prevention
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]
[…] surgical approach was modified to reconstitute blood flow to the subclavian artery via transposition of its distal aspect to the carotid and is now considered standard of care. 8 In young patients, division of Kommerell diverticulum is warranted to prevent [jamanetwork.com]
To learn more or modify/prevent the use of cookies, see our Cookie Policy and Privacy Policy. A 74-year-old woman was referred to our unit with a chief complaint of dysphagia. [researchgate.net]
A valve system in place here prevents the absorbed lymph from leaking back into the ISF, there is another system of semilunar valves that prevents back-flow of lymph along the lumen of the vessel. [wikivisually.com]