Vol.103 No.2 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 103 No. 2 February 2010
Discomfort in Swallowing Caused by an Aberrant Right Subclavian Artery
Miki Ikehata, Naoki Saka and Masafumi Sakagami
(Hyogo College of Medicine)
Toru Seo
(Osaka Central Hospital)
An aberrant right subclavian artery (ARSA), an ordinarily asymptomatic vascular anomaly arising from the aorta distal to the usual left subclavian artery origin, may cause dysphagia when the artery passing behind the esophagus, extrinsically compresses the trachea or esophagus. This discomfort is commonly seen in otolaryngology, but rarely reported. We report a case of ARSA-induced dysphagia.
A 68-year-old, woman seen for dysphagia showed no abnormal findings in physical, larynx or pharynx examination, including fiberscopy. Contrast-enhanced computed tomography (CT), however, showed an abnormal artery arising from the aortic arch between the esophagus and spine. Esophagography showed an extrinsic defect following an inferior to superior (left to right) course consistent with the artery. Three-dimensional (3D) CT angiography clearly showed the artery originating in the aortic arch, yielding a definitive diagnosis of ARSA. Because the symptom was mild, the woman was told of the finding and followed up without treatment.
Key words :aberrant right subclavian artery, dysphagia lusoria, esophagography