Roofthooft Marcus T R, van Meer Hester, Rietman Wim G, Ebels Tjark, Berger Rolf M F
Department of Paediatric Cardiology, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9700, Groningen, The Netherlands.
Eur J Pediatr. 2008 Sep;167(9):1033-6. doi: 10.1007/s00431-007-0637-2. Epub 2008 Jan 3.
Down syndrome (DS) may be associated with various organ system disorders. Feeding problems are frequent in children with DS and may be caused by associated defects, including congenital heart defects, gastrointestinal defects, or endocrine disorders. In the absence of these associated conditions, feeding problems are often attributed to general hypotonia. However, an aberrant right subclavian artery (ARSA), a rare vascular anomaly and an unusual cause of problems with the passage of solid food through the esophagus, has recently been suggested to occur more frequently in patients with DS. This knowledge is of importance when evaluating feeding difficulties in patients with DS. Additional investigation for identifying an ARSA may be indicated in selected patients. Diagnostic techniques, such as transthoracic echocardiography, barium contrast esophagram, angiography, or computed tomography-angiography (CT) can be used in a diagnostic flow chart. The presence of ARSA is not synonymous to the cause of feeding problems in patients with DS and corrective surgery of this vascular anomaly should be restricted to selected cases.
唐氏综合征（DS）可能与多种器官系统疾病相关。喂养问题在唐氏综合征患儿中很常见，可能由相关缺陷引起，包括先天性心脏缺陷、胃肠道缺陷或内分泌紊乱。在没有这些相关病症的情况下，喂养问题通常归因于全身肌张力减退。然而，最近有人提出，异常右锁骨下动脉（ARSA），一种罕见的血管异常，也是固体食物通过食管困难的不寻常原因，在唐氏综合征患者中更频繁地出现。在评估唐氏综合征患者的喂养困难时，这一认识很重要。对于选定的患者，可能需要进一步检查以确定是否存在ARSA。诊断技术，如经胸超声心动图、钡剂食管造影、血管造影或计算机断层血管造影（CT），可用于诊断流程图。ARSA的存在并不等同于唐氏综合征患者喂养问题的原因，这种血管异常的矫正手术应仅限于选定的病例。
