一个异常的右下关节动脉导致严重的食道压缩:一个案例报告
Nektarios Galanis1, Dimosthenis Chrysikos1, Michail Palaios1
1Anatomy, National and Kapodistrian University of Athens School of Medicine, Athens, GRC.
Cureus
|March 27, 2025
概括
异常的右下关节动脉 (ARSA) 可能会导致因食道压缩而导致的松症 (DL). 这一案例突出了诊断的先进成像技术以及监测这种血管异常患者的重要性.
科学领域:
- 心血管医学 心血管医学
- 血管外科 血管外科
- 诊断成像 诊断成像 诊断成像
背景情况:
- 异常右下关节动脉 (ARSA) 是一种先天性血管异常.
- ARSA可能导致食道压缩,导致松症 (DL).
- DL症状包括难以吞和疼痛,可能导致体重减轻.
研究的目的:
- 为了呈现一种由ARSA引起的食障碍lusoria病例.
- 强调高级成像在诊断DLL中的作用.
- 讨论对ARSA次要的DL的管理选项.
主要方法:
- 一个44岁的男性患者的病例报告.
- 利用计算机断层扫描血管造影 (CTA) 进行诊断.
- 审查了临床表现,成像发现和治疗考虑.
主要成果:
- 由于 ARSA 和 Kommerell 的分泌器对食道进行了压缩,该患者出现了严重的消化不良和消化不良.
- CTA证实了动脉的异常起源和逆食道路径.
- 建议进行外科手术,但选择了保守的管理.
结论:
- 先进的成像对于诊断ARSA的二次性松症至关重要.
- 对ARSA诱导的DL的管理决策需要仔细考虑患者因素.
- 持续监测对于患有这种血管异常的患者来说至关重要,以管理并发症.
相关概念视频
Esophageal Varices-I: Introduction
53
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
53
Esophageal Perforation-II: Clinical Manifestations and Management
29
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
29
Esophageal Strictures-I: Introduction
44
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
44
Esophageal Strictures-II: Clinical Features and Management
27
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.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
27
Esophageal Perforation-I: Introduction
54
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
54
Esophageal Varices-II: Clinical Features and Management
32
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
32


