CASE 15694 Published on 20.04.2018
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Dysphagia lusoria – A rare clinical entity in the adult

Section

Chest imaging

Case Type

Clinical Cases

Authors

D. Campos Correia, E. Bandeira, F. Cruz, R. Cabral, I. Amaral

Centro Hospitalar de Lisboa Ocidental;
Rua da Junqueira, 126
1349-019 Lisboa, Portugal;
Email:davidcorreia7@gmail.com
Connected authors
David Correia PORTUGAL
Patient

40 years, female

Categories
Area of Interest Arteries / Aorta ; Imaging Technique Conventional radiography, CT
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Clinical History
A 40-year-old otherwise healthy woman presented with a long-standing history of mild dysphagia to solids. Fiberoptic endoscopic evaluation and upper gastrointestinal endoscopy were unremarkable.
Imaging Findings
A barium swallow was performed revealing an oblique indentation of the upper oesophagus with a left-to-right trajectory, consistent with an aberrant right subclavian artery (Fig. 1 a, b). CT angiography confirmed the presence of an aberrant right subclavian artery arising distally from the aortic arch with a retro-oesophageal course, slightly compressing the oesophagus (Figure 2 a, b and c).
Discussion
Aberrant origin of the right subclavian artery is the most frequent developmental anomaly of the aortic arch [1]; however, it does not usually cause oesophageal impairment [1]. In these cases, such an entity is termed dysphagia lusoria. Adult onset is extremely rare [2]. Surgery is reserved for patients with prominent symptoms or aneurysmal dilation. Re-establishment of flow by reimplantation or bypass is currently the method of choice [3].
Because the dysphagia was only mild, no surgical correction was performed.
Differential Diagnosis List
Dysphagia lusoria
Tumour
Gastro-oesophageal reflux disease
Final Diagnosis
Dysphagia lusoria
Case information
URL: https://www.eurorad.org/case/15694
DOI: 10.1594/EURORAD/CASE.15694
ISSN: 1563-4086
License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Figure 1

Barium swallow

Barium swallow
AP (left) and lateral (right) view of a barium swallow examination showing an oblique indentation in the upper oesophagus.
Barium swallow
AP (left) and lateral (right) view of a barium swallow examination showing an oblique indentation in the upper oesophagus (red markers).
Figure 2

CT

CT
CT (axial view) showing an aberrant right subclavian artery arising distally from the aortic arch (arrow).
CT
CT (coronal view) showing an aberrant right subclavian artery arising distally from the aortic arch (arrow).
CT
CT (sagittal view) showing an aberrant right subclavian artery arising distally from the aortic arch (arrow).