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Arterio-esophageal communication from a ruptured aberrant right subclavian artery aneurysm. CT diagnosis
N K Singha1, S J Hale, J E Kuhlman
1Department of Radiology, University of Wisconsin Medical School, Madison, USA.
Insights
Computed tomography (CT) revealed an arterio-esophageal fistula caused by an aberrant right subclavian artery aneurysm eroding into the esophagus. This is the first CT demonstration of this rare condition, aiding antemortem diagnosis.
Area of Science:
- Vascular surgery
- Radiology
- Gastroenterology
Background:
- Aberrant right subclavian artery (ARSA) is a rare congenital anomaly.
- Aneurysms of aberrant subclavian arteries can lead to serious complications.
- Arterio-esophageal communication is a life-threatening condition.
Observation:
- Computed tomography (CT) demonstrated an arterio-esophageal communication.
- The communication originated from an aneurysm of an aberrant right subclavian artery.
- The aneurysm had eroded into the esophagus.
Findings:
- This is the first reported case of an arterio-esophageal communication due to an aberrant right subclavian artery aneurysm demonstrated by CT.
- Previous literature described a similar case involving a left aberrant subclavian artery aneurysm.
- CT findings, including vessel location, aneurysmal dilation, and intramural air, facilitated antemortem diagnosis.
Implications:
- CT imaging is crucial for diagnosing rare vascular anomalies and their complications.
- Early diagnosis of arterio-esophageal fistula is vital for timely intervention.
- Understanding CT features aids in differentiating this condition from other esophageal pathologies.
Abstract:
We report the computed tomography (CT) findings of an arterio-esophageal communication from an aberrant right subclavian artery aneurysm which had eroded into the esophagus. Pathologic correlation is provided. To our knowledge, this is the first CT demonstration of an aberrant right subclavian aneurysm causing a communication to the esophagus reported in the literature. Previously, one CT case of a left aberrant subclavian artery aneurysm that had ruptured into the esophagus, had been described. The characteristic location of the aberrant vessel with aneurysmal dilation and the presence of abnormal air identified within the wall of the aneurysm on CT, helped establish the diagnosis antemortem.