Hiller H G, Lagattolla N R F
Department of General and Vascular Surgery, Dorset County Hospital, Dorchester, UK.
Thorac Surg Sci. 2007 Feb 26;4:Doc01.
Extrinsic oesophageal compression leading to dysphagia is a recognised but uncommon sole presentation of thoracic aortic aneurysms. This has been referred to as Dysphagia Aortica, and is a late presentation of large thoracic aneurysms, or a symptom of impending aorto-oesophageal fistula. We present the case of a 67 year old woman who presented repeatedly with dysphagia and weight loss over a 3 month period to specialists in three different disciplines. Eventually, a type II thoraco-abdominal aortic aneurysm causing extrinsic compression of the oesophagus was discovered. When dealing with patients who present with dysphagia, if no other cause is discovered, a thoracic aortic aneurysm should form part of the differential diagnosis, as this is potentially curable, and delays in diagnosis and treatment predispose to rupture and death.
导致吞咽困难的食管外压迫是一种已被认识到但不常见的胸主动脉瘤单一表现形式。这被称为主动脉性吞咽困难，是大型胸主动脉瘤的晚期表现，或是即将发生主动脉食管瘘的症状。我们报告一例67岁女性患者，她在3个月内反复出现吞咽困难和体重减轻，先后就诊于三个不同学科的专家。最终，发现了一个导致食管外压迫的II型胸腹主动脉瘤。在处理出现吞咽困难的患者时，如果未发现其他病因，胸主动脉瘤应作为鉴别诊断的一部分，因为这有可能治愈，而诊断和治疗的延迟易导致破裂和死亡。
