Dysphagia lusoria: clinical aspects, manometric findings, diagnosis, and therapy

Janssen, M.; Baggen, M.G.A.; Veen, Hermanus F; Smout, A. J. P. M.; Bekkers, Jos A.; Jonkman, Jeroen G.J.; Ouwendijk, Rody

doi:10.1111/j.1572-0241.2000.02071.x

Cited by 146 publications

(104 citation statements)

References 11 publications

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“…These imaging findings showed good correlation with the mild-moderate dysphagic symptoms in our patient (grade 2 dysphagia [9] ). Cine-MRI has not been previously used to evaluate esophageal motility, and its ability to demonstrate esophageal impingement sites requires to be assessed by more extensive studies.…”

Section: Discussionsupporting

confidence: 51%

“…Barium esophagogram and esophageal fiber-optic endoscopy may demonstrate luminal narrowing due to extrinsic esophageal compression with an intact mucosa, excluding other causes of dysphagia [3][4][5][6] . Manometric investigation reveals nonspecific abnormalities [9] . Digital subtraction angiography provides complete and detailed information regarding mediastinal vascular anatomy, however, extravascular structures are not visualized.…”

Section: Discussionmentioning

confidence: 99%

“…The work-up of an adult patient with dysphagia, besides a high index of suspicion, includes standard chest radiography, barium esophagogram, esophageal manometry and esophageal fiber-optic endoscopy. Cross-sectional imaging techniques (MDCT, digital subtraction angiography, MRI and MRA) [3][4][5]9] are used to depict vascular rings and aberrant vessels in dysphagia lusoria.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac-MRI demonstration of the ligamentum arteriosum in a case of right aortic arch with aberrant left subclavian artery

Paparo

Bacigalupo²,

Melani³

et al. 2012

WJR

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Right-sided aortic arch with aberrant left subclavian artery (RAA/ALSC) is the second most common mediastinal complete vascular ring. Adult presentation of dysphagia lusoria due to a RAA/ALSC is uncommon with fewer than 25 cases reported in the world literature. The left lateral portion of this vascular ring is not a vessel, but an atretic ductus arteriosus, the ligamentum arteriosum, which has been identified in different cases as the major cause of tracheo-esophageal impingement. Surgical division of the ligamentum arteriosum allows the vessels to assume a less constricting pattern decreasing dysphagic symptoms. Clear visualization of the ligamentum arteriosum by diagnostic imaging has not been obtained in previously reported cases. We demonstrated, using magnetic resonance imaging, the location and the complete course of a left-sided ligamentum arteriosum in a patient with adult-onset dysphagia due to a RAA/ALSC with a small Kommerell' s diverticulum, providing, during the same session, a complete assessment of both mediastinal vascular abnormalities and esophageal impingement sites.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac-MRI demonstration of the ligamentum arteriosum in a case of right aortic arch with aberrant left subclavian artery

Paparo

Bacigalupo²,

Melani³

et al. 2012

WJR

View full text Add to dashboard Cite

show abstract

“…Contrast enhanced computed tomography scan, magnetic resonance imaging or conventional angiography will provide further information about the type and extent of lesion, which is extremely helpful in preoperative planning [8,30,47,59]. In cases of RERSA, the barium swallow of the oesophagus is a very helpful diagnostic tool, which will reveal the typical impression defect, while endoscopically a pulsatile mass may be discovered [33]. Treatment is indicated especially in cases of paediatric dysphagia.…”

Section: Discussionmentioning

confidence: 99%

Retro-oesophageal right subclavian artery in association with thyroid ima artery: a case report, clinical impact and review of the literature

et al. 2016

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“…1 Barium contrast examination of the esophagus is a good diagnostic tool, demonstrating a characteristic impression defect at the level of the third and fourth vertebra 5 ; CTA and/or angiography usually are the best examinations to confirm the diagnosis. 5 Due to the rarity of this condition, indications for surgical intervention have been described, but not fully agreed upon. These include symptomatic patients with an ARSA with or without KOD, or patients in whom the KOD aneurysmal degeneration is >3 cm.…”

Section: E10 Case Reportsmentioning

confidence: 99%

Mediastinoscopy-assisted Treatment of an Aberrant Right Subclavian Artery

Varetto

Castagno

Trevisan

et al. 2016

Annals of Vascular Surgery

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Aberrant right subclavian artery (ARSA) is a rare congenital anomaly characterized by the origin of the right subclavian artery from the aortic arch distally to the left subclavian artery. We describe the case of a young patient with symptomatic ARSA treated by mediastinoscopyassisted ligation at its origin and subclavianecarotid transposition.The aberrant right subclavian artery (ARSA) is a rare congenital anomaly characterized by a retroesophageal course of the right subclavian artery, whose origin from the aortic arch is distal to the left subclavian artery. The majority of patients with ARSA are asymptomatic; however, this anomaly may cause a condition named dysphagia lusoria. CASE REPORTA 36-year-old woman was referred to our center for a history of progressively worsening dysphagia and severe loss of weight. The patient reported an initial dysphagia for solids which had started 2 months prior. This has recently progressed to a dysphagia for liquids as well. Both neurological and otolaryngology evaluations were negative for organic or functional swallowing impairments. Due to her malnourished conditions, parental nutrition was administered. Videofluoroscopy was then performed and demonstrated an external compression during bolus progression in the proximal zone of esophagus on the anterolateral left side of the esophagus. This finding was considered highly suggestive for an ARSA. A computed tomography angiography (CTA) confirmed the diagnosis of an 8-mm ARSA and also revealed the associated anomalous origin of the left common carotid artery from the innominate trunk (Fig. 1). Due to the significant symptoms, surgical intervention was then planned. Under general anesthesia, the patient was placed in the supine position. A sandbag was positioned in the midline behind her shoulders to achieve a better extension of the neck. Through a 6 cm right supraclavicular incision, we sectioned the clavicular head of the sternocleidomastoid muscle and the anterior scalene muscle, after identification of the phrenic nerve. This helped to expose the ARSA, the mammary artery, the thyreocervical trunk, and the right vertebral artery. Then, with the use of a mediastinoscope, we followed the proximal aberrant subclavian artery in the retroesophageal space until 1 cm from its origin off the aortic arch. After systemic heparinization, a curved Satinsky vascular clamp was placed at the origin of ARSA (Fig. 2A); then, we oversewed the proximal portion of this artery as close to its origin as possible with a 2 Mersilene suture and transected it. The distal portion of the right subclavian artery was trimmed and with a careful preservation of the right vertebral artery, an end-to-side anastomosis was made with the right common carotid artery with a polypropylene 6-0 (Fig. 2B). No intraoperative complications occurred. Her postoperative course was uneventful and she tolerated regular diet with immediate regression of her dysphagia. On second postoperative day, a Gastrografin transit confirmed the absence of any obstruction in the esoph...

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Dysphagia lusoria: clinical aspects, manometric findings, diagnosis, and therapy

Cited by 146 publications

References 11 publications

Cardiac-MRI demonstration of the ligamentum arteriosum in a case of right aortic arch with aberrant left subclavian artery

Cardiac-MRI demonstration of the ligamentum arteriosum in a case of right aortic arch with aberrant left subclavian artery

Retro-oesophageal right subclavian artery in association with thyroid ima artery: a case report, clinical impact and review of the literature

Mediastinoscopy-assisted Treatment of an Aberrant Right Subclavian Artery

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