China
Africa
Explore chapters and articles related to this topic
The Aorta and Related Disorders (except trauma).
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
(b) An aberrant right subclavian artery (present in about 1 in 200 of the population - Comer et al., 1972) sometimes causes 'dysphagia lusoria' ('lusus naturae' = a 'sport of nature', in this case caused by an abnormal R subclavian artery). In most cases the 'aberrant vessel' passes behind the oesophagus. Occasionally the anomaly may be noted on plain radiographs by the presence of a 'knob' lying just behind the plane of the trachea on lateral views. Mostly it is discovered on barium swallow examinations as an indentation angled upwards from left to right towards the right first rib (Fig. 10.2 and Illus. SUBCLAV ART ABERRANT), Occasionally its origin from the aorta may give rise to a 'diverticulum of Kommerell' which is usually an incidental finding. Sometimes however it may be large, equalling the size of the aorta, or even larger if aneurysmal - see also note on p. 10.2 and reference to Kommerell p. 10.5.
Hamburg classification: Controversy with the benefit and liability
Published in Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic, Vascular Malformations, 2019
Peter Gloviczki, David J. Driscoll
Truncular malformations occur due to a defect that occurs later in development, in stage 3, the maturation stage. Truncular lesions affect major vascular channels, frequently named arteries or veins, and no longer exhibit the evolutional potential to grow.5 Their hemodynamic effects can be significant. These can be persistent embryonic vessels or congenital defects or lesions affecting normal vessel development, presenting with obstruction due to aplasia, hypoplasia, or sometimes hyperplasia or with stenosis due to coarctation, membranous occlusion/stenosis, or congenital spurs. The wall of truncular lesions is frequently weak, causing localized dilations and frank aneurysms. Diffuse dilations present as ectasia, mega-arteries, or veins. A persistent sciatic artery or a persistent sciatic vein is a truncal malformation and so is a persistent lateral embryonic vein, frequently seen in patients with Klippel–Trenaunay syndrome (Figure 2.1).17–19 These also include arterial malformations like an aberrant left subclavian artery that runs behind the esophagus and causes dysphagia lusoria. Thoracic or abdominal aortic coarctations,20 anomalies of the aortic arch, or persistence of embryonic mesenteric vessels, are additional examples.
Multidetector Row CT Angiography of the Thoracic Aorta
Published in Phillip M. Boiselle, Charles S. White, New Techniques in Cardiothoracic Imaging, 2007
Curtis E. Green, Jeffrey S. Klein
Aberrant origin of the right subclavian artery occurs when the embryological right arch becomes atretic between the origins of the right common carotid artery and the right subclavian artery, and is said to occur in between 1/200 and 1/250 persons. The incidence is increased in Tetralogy of Fallot and coarctation of the aorta. The situation is a mirror image of the Type 2 right aortic arch, with the right subclavian artery arising from the proximal descending aorta. The right ductus almost always disappears and this anomaly is, therefore, rarely associated with a vascular ring. The origin of the aberrant vessel may be quite dilated, in which case it is referred to as the diverticulum of Kommerell. Occasionally the diverticulum of Kommerell enlarges to the point where it compresses on the esophagus (Fig. 6A). Traditionally these have been blamed for dysphagia (dysphagia lusoria), but not all clinicians and investigators accept a causal association. An aberrant right subclavian artery may present as a right supraclavicular mass on the frontal chest radiograph and may be more prone to aneurysm formation than the normally arising right subclavian artery (Fig. 6B).
The non-recurrent inferior laryngeal nerve: The clinical and surgical implication
Published in Acta Oto-Laryngologica Case Reports, 2021
Cissé Naouma, Koné Fatogoma Issa, Haïdara Abdoul Wahab, Kassim Diarra, N’faly Konaté, Kalifa Coulibaly, Siaka Soumaoro, Boubacary Guindo, Singaré Kadidiatou, Timbo Samba Karim, Mohamed Amadou Kéïta
The recurrent laryngeal nerve is a cervical branch of the vagus nerve that supplies motor, sensory and parasympathetic nerve fibers to the larynx [1,2]. Non-recurrence of the nerve is a rare anatomical variant [3]. The first case was reported in 1823 by Stedman [4]. This variation is constantly associated with vascular malformations due to an abnormality in the development of the sixth brachial arch [5,6]. One series found a non-recurrent lower right laryngeal nerve at 0.6% in 4921 right cervical dissections and a non-recurrent lower left laryngeal nerve at 0.04% in 4673 left cervical dissections [3,6]. The circumstances of discovery is either:By indirect signs. The symptom ‘dysphagia lusoria’ is an impairment of swallowing due to compression from an aberrant right subclavian artery (arteria lusoria). it‘s most often associated with the non-recurrent inferior laryngeal nerve [1,2,5]. Preoperative imaging using ultrasound, computed tomography and angiography allows us to find predictive signs of the non-recurrent laryngeal nerve, notably an aberrant right subclavian artery, a right retro-oesophageal or pre-oesophageal artery, a situs invertus [5–7].Intraoperative which is the most frequent.
Arteria lusoria: a trick of nature
Published in Scandinavian Journal of Gastroenterology, 2021
Sarah S. Jakobsen, Jens B. Frøkjaer, Anders C. Larsen
In arteria lusoria the aberrant right subclavian artery (ARSA) arises as the leftmost branch on the aorta and courses upward towards the right side. This trajectory can be done retro esophageal, between the esophagus and trachea, or in front of the trachea. Dysphagia lusoria may occur when ARSA compresses the esophagus leading to difficulty in swallowing solids and retrosternal pain. Other symptoms such as weight loss, dyspnea or coughing can be caused by tracheal compression [2,5]. The posterior course of the ARSA in our patient produced a compression likely leading to dysphagia, retrosternal pain and weight loss. Like most people who are born with the anomaly, our patient was mostly asymptomatic until recently. The reason for the late worsening of symptoms is still unclear but may be explained by age-related alterations such as arterial elongation, arteriosclerotic rigidity and increased rigidity of the trachea [6].
Dysphagia lusoria in a young woman with chest pain
Published in Baylor University Medical Center Proceedings, 2022
Busara Songtanin, Roy Jacob, Neha Mittal
Dysphagia lusoria is a rare condition caused by extrinsic compression of the esophagus by an aberrant subclavian artery. Symptoms usually begin due to atherosclerotic changes in the vessels and include dysphagia and retrosternal chest pain.