Published online Apr 21, 2013. doi: 10.3748/wjg.v19.i15.2433
Revised: February 19, 2013
Accepted: March 6, 2013
Published online: April 21, 2013
Dysphagia lusoria is a term used to describe dysphagia secondary to vascular compression of the oesophagus. The various embryologic anomalies of the arterial brachial arch system often remain unrecognised and asymptomatic, but in 30%-40% of cases can result in tracheo-oesophageal symptoms, which in the majority of cases manifest as dysphagia. Diagnosis of dysphagia lusoria is via barium swallow and chest Computed tomography scan. Manometric abnormalities are variable, but age-related manometric changes may contribute to clinically relevant dysphagia lusoria in patients who present later in life. Our report describes a case of late-onset dysphagia secondary to a right aortic arch with an aberrant left subclavian artery, which represents a rare variant of dysphagia lusoria. The patient had proven additional oesophageal dysmotility with solid bolus only and a clinical response to dietary modification.
Core tip: Dysphagia lusoria is a term used to describe dysphagia as a consequence of vascular compression of the oesophagus. Our case describes a rare anatomical variant of a right-sided aortic arch with aberrant left subclavian artery with late onset dysphagia. Manometric studies were abnormal with solid bolus, likely contributing to the worsening of the patient’s symptoms over time. The patient is managing to maintain weight and nutrition through dietary modification and no operative intervention is currently planned.