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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
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[Dysphagia lusoria treated by surgery].

Natacha Mawait1, Arnaud Kerzmann1, Quentin Desiron1

  • 1Service de Chirurgie cardiovasculaire et thoracique, CHU Liège, Belgique.

Revue Medicale De Liege
|August 10, 2023
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Summary

Aberrant right subclavian artery, a common aortic arch anomaly, often causes dysphagia lusoria in adults. Surgical transposition effectively treats symptomatic cases, as demonstrated in a 50-year-old woman.

Keywords:
DysphagiaLusoriaSubclavian ArteryTransposition

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Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Congenital Anomalies

Background:

  • Aberrant right subclavian artery (ARSA), or arteria lusoria, is the most frequent congenital anomaly of the aortic arch, affecting 0.5-1.8% of the population.
  • Prevalence is significantly higher in patients with trisomy 21 (35%).
  • ARSA arises from the aortic arch distal to other supra-aortic vessels and can be associated with other cardiovascular defects.

Observation:

  • Typically located retroesophageally in over 80% of cases.
  • Often asymptomatic, but can manifest later in life (post-40 years) with symptoms like dysphagia, dyspnea, or cough, particularly in women.
  • Dysphagia lusoria is a characteristic symptom.

Findings:

  • Diagnosis is confirmed via advanced imaging modalities such as computed tomography (CT) or magnetic resonance imaging (MRI).
  • Barium contrast radiography of the esophagus is indicated for symptomatic evaluation.
  • Surgical treatment, specifically transposition of the aberrant vessel, is reserved for symptomatic individuals.

Implications:

  • This case highlights the successful surgical management of dysphagia lusoria in a 50-year-old woman via cervical transposition of the aberrant right subclavian artery.
  • Effective treatment options exist for symptomatic arteria lusoria, improving patient quality of life.
  • Understanding ARSA's prevalence and clinical presentation is crucial for timely diagnosis and management.