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• W2978130143 abstract "Intro: Right-sided aortic arch is a rare anatomical variant in which the aortic arch is on the right side rather than on the left, wrapping behind the esophagus. It occurs in approximately 0.1% of the population and it may have Kommerell diverticula. This refers to the bulbous configuration of the origin of an aberrant left subclavian artery in the setting of a right sided aortic arch which could compress the esophagus, causing “Dysphagia Lusoria”. Case: A 49 year old man presented to emergency room with complaint of severe epigastric and sub-sternal chest pain, associated with GERD symptoms, several times during the past year. Patient had thorough work up including unremarkable CT scan of abdomen/pelvis with contrast, EGD which showed a suspicious 3 cm sub-mucosal lesion of anterior wall of stomach. Biopsy of the lesion was unremarkable but patient was found to have H-Pylori gastritis which was treated with no improvement of the symptoms. MRI with contrast and EUS for further evaluation of the sub-mucosal gastric lesion were performed but did not reveal anyapparent abnormality. Course of disease gradually deteriorated with weight loss, dysphagia, dyspnea, cold hands and pre-syncope, which led the patient to another ED visit. CT scan of neck with contrast, followed by CT-Angiogram of the chest, and barium esophagogram confirmed the diagnosis of Kommerell's Diverticulum related to a right sided aortic arch, displacing and compressing the Trachea and Esophagus respectively. Patient's symptoms improved after resection of aortic band and repair of the Kommerell's diverticulum. Discussion: Dysphagia Lusoria is a term used to describe dysphagia as a consequence of vascular compression of the esophagus. The various embryologic anomalies of arterial brachial arch system often remain unrecognized and asymptomatic, but in 30%-40% of cases, can result in trachea-esophageal symptoms, which in the majority of the cases manifest as dysphagia. This reported patient was symptomatic with sub-sternal pain and weight loss for months before development of symptoms secondary to compression. High suspicious for vascular anomalies as the cause of Gastrointestinal symptoms specifically dysphagia, where more common causes are absent, may lead to earlier diagnosis and improved clinical outcomes.Figure 2Figure 2" @default.
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• W2978130143 date "2016-10-01" @default.
• W2978130143 modified "2023-09-27" @default.
• W2978130143 title "Kommerellʼs Diverticulum and Right-Sided Aortic Arch: A Case of a Refractory Epigastric Pain Prior to Development of Dysphagia and Dyspnea" @default.
• W2978130143 doi "https://doi.org/10.14309/00000434-201610001-01662" @default.
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