Dysphagia Lusoria: Is the Dysmotility Connection Illusory or Real?

Coles, Michael; Sharma, Amol

doi:10.1007/s10620-020-06152-2

Cited by 12 publications

(21 citation statements)

References 16 publications

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“…Diagnostic imaging studies have been successful in identification of anomalous vasculature. However, the majority of these patients remain asymptomatic despite classical radiological findings 2,10 . Dynamic esophageal testing by HRiM alone has not shown a strong correlation with clinically significant dysphagia in prior studies 9 .…”

Section: Discussionmentioning

confidence: 95%

Dysphagia lusoria: utility of high‐resolution impedance manometry to identify true disease

Wellington

Kim

Castell

et al. 2021

Neurogastroenterology Motil

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Dysphagia lusoria is a rare cause of dysphagia due to impingement of the esophagus by an aberrant right subclavian artery. Although most remain asymptomatic, this aberrant vessel can lead to progressive dysphagia in childhood or even later in life as a result of arteriosclerotic burden and attenuation of esophageal compliance that led to esophageal compression. We present a 56‐year‐old man with a 3‐year history of progressively worsening dysphagia to solids and liquids and globus sensation. Videofluoroscopic swallowing study (modified barium esophagram) and barium esophagram showed delayed barium tablet transit in the upper esophagus and focal smooth narrowing of the upper esophagus caused by external compression, respectively. Computed tomography imaging demonstrated external compression of proximal esophagus from an aberrant right subclavian artery with high atherosclerotic burden. In addition, high‐resolution impedance manometry (HRiM) revealed a striking high‐pressure pulsatile vascular band in the proximal esophagus (108 mmHg) associated with poor bolus transit, demonstrating the utility of HRiM in strengthening the diagnoses of true dysphagia lusoria.

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Section: Discussionmentioning

confidence: 95%

Dysphagia lusoria: utility of high‐resolution impedance manometry to identify true disease

Wellington

Kim

Castell

et al. 2021

Neurogastroenterology Motil

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“…It is estimated that in a general population, the prevalence of DL is 0.4%-0.7%, and the incidence of ARSA is 0.5%-1.8% [2,6]. Since 60%-80% of patients with an ARSA will remain asymptomatic throughout their lifetime, the diagnosis of DL is incredibly rare [2,7]. ARSA's can be found incidentally during esophageal tests (barium esophagram) while evaluating for other causes [2,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Since 60%-80% of patients with an ARSA will remain asymptomatic throughout their lifetime, the diagnosis of DL is incredibly rare [2,7]. ARSA's can be found incidentally during esophageal tests (barium esophagram) while evaluating for other causes [2,7,8]. Once an ARSA is confirmed with a CT scan or MRI, patients are managed either conservatively or with surgical vascular decompression [2,7].…”

Section: Introductionmentioning

confidence: 99%

Dysphagia Lusoria Causing Aspiration Pneumonitis in a Patient With Recurrent Pancreatitis

Sateesh¹,

Gousy²,

Prajapati³

et al. 2022

Cureus

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Dysphagia lusoria (DL) occurs due to an aberrant right subclavian artery (ARSA) compressing the esophagus resulting in dysphagia, odynophagia, and/or reflux symptoms. It is diagnosed by barium esophagram followed by a CT scan or MRI. In this case report, there is a 44-year-old male with a chronic history of reflux and a cough that presents after a meal. The case was complicated due to the history of the patient's alcoholism with recurrent pancreatitis. A CT scan was obtained during his admission, which showed pleural effusion, atelectasis, aspiration pneumonia, and an incidental aberrant RCA. Although DL is a rare pathology, 60%-80% of patients remain asymptomatic, and patients with symptoms can be managed conservatively or surgically, depending on their severity.

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“…This may manifest clinically with symptoms of dysphagia or reflux. 1 The anomaly most commonly involves the right subclavian artery (0.5-2.0% of the population) or, rarely, the left subclavian artery (LSA) when there is a right-sided aortic arch (0.05-0.1%) and left-sided ligamentum arteriosum. 2 The latter constitutes a true vascular ring, which typically constricts the esophagus and trachea more significantly when compared with an aberrant RSA, which is classified as a noncircumferential vascular sling.…”

Section: Introductionmentioning

confidence: 99%

“…Dysphagia lusoria is a rare embryologic defect of the aortic arch vasculature characterized by an aberrant retroesophageal course of the right subclavian artery (RSA), comprising a vascular sling. This may manifest clinically with symptoms of dysphagia or reflux 1. The anomaly most commonly involves the right subclavian artery (0.5–2.0% of the population) or, rarely, the left subclavian artery (LSA) when there is a right‐sided aortic arch (0.05–0.1%) and left‐sided ligamentum arteriosum 2.…”

Section: Introductionmentioning

confidence: 99%

Dysphagia lusoria: A vascular etiology?

et al. 2020

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Dysphagia lusoria is difficulty swallowing as a result of extrinsic esophageal compression by an aberrant right subclavian artery (ARSA). We present the case of a 59‐year‐old patient with ARSA and history of chronic dysphagia. Vascular decompressive surgery was performed, but it failed to resolve his symptoms. Esophageal manometry indicated concomitant esophageal gastric junction outflow obstruction in the setting of a small hiatal hernia. Our case highlights the diagnostic dilemma surrounding dysphagia lusoria and identification of cases that should undergo surgical repair. Based on a thorough review of the literature and our case, we propose a complete foregut workup for possible other causes as potential etiologies of dysphagia prior to surgical treatment of dysphagia lusoria.

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Dysphagia Lusoria: Is the Dysmotility Connection Illusory or Real?

Cited by 12 publications

References 16 publications

Dysphagia lusoria: utility of high‐resolution impedance manometry to identify true disease

Dysphagia lusoria: utility of high‐resolution impedance manometry to identify true disease

Dysphagia Lusoria Causing Aspiration Pneumonitis in a Patient With Recurrent Pancreatitis

Dysphagia lusoria: A vascular etiology?

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