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• W2914473600 abstract "The term Dysphagia Lusoria, which stands for “freak of nature,” was coined by Bayford in 1794, which he used to describe dysphagia in an elderly woman who died of esophageal obstruction and subsequent weight loss as a result of the aberrant right subclavian retro-esophageal artery. CASE REPORT: A 65-year-old male presented to the ED with a nonproductive cough for one month and difficulty swallowing solids for one week. The patient stated the cough was initially intermittent and dry in nature and progressed in persistency with a noticeable dysphagia to solid foods. He said that he had lost about 10 pounds since the onset of solid food dysphagia. He denied progression of dysphagia to liquid. His past medical history was significant for asbestos exposure and he had a 5 pack year smoking history with continued episodic alcohol intake of 12 beers per week. The patient was subsequently admitted to the hospital and an esophagram was performed which revealed an aberrant right subclavian artery impression in the posterior wall of esophagus. General surgery was consulted and an EGD was performed that showed gastritis and duodenitis and the patient was started on a PPI and sucralfate. Vascular surgery was also consulted for the suspected aberrant right subclavian and recommended a CTA chest which was consistent with aberrant right subclavian artery, as well as calcified pleural plaques. No surgical intervention was recommended. The patient was counseled on smoking and alcohol abuse and educated about his condition causing dysphagia. DISCUSSION: In the majority of cases, dysphagia lusoria is asymptomatic or presents with mild dysphagia. A small minority of adult patients, however, have a severe symptoms leading to an inability to swallow and subsequent malnutrition. Hence, the coined name dysphagia lusoria. In children, it can present as stridor and repeated chest infections due to tracheal softening, whereas in adults, it presents mainly with difficulty in swallowing and in severe cases, failure to thrive. Due to nonspecificity of the symptoms and nondiagnostic endoscopy in most of the cases, the diagnosis of dysphagia lusoria can be challenging. For mild to moderate symptomology, lifestyle modifications including changes in diet and reassurance are recommended. More severe cases require surgical ntervention. Dysphagia lusoria, although a rare cause of symptomatic dysphagia, is a diagnosis that should be considered due to its difficulty of confirmation.Figure: Barium swallow showing impression in the posterior wall of upper thoracic esophagus at cervicothoracic junction area correlating with vascular impression from the aberrant right subclavian artery.Figure: Sagittal view of CTA scan showing aberrant subclavian artery compressing the esophagus.Figure: Axial view of CTA scan showing aberrant subclavian artery compressing the esophagus." @default.
• W2914473600 created "2019-02-21" @default.
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• W2914473600 date "2017-10-01" @default.
• W2914473600 modified "2023-09-25" @default.
• W2914473600 title "Difficult to Swallow: A Case of Dysphagia Lusoria" @default.
• W2914473600 doi "https://doi.org/10.14309/00000434-201710001-01754" @default.
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