Barone Claudia, Carucci Nicolina Stefania, Romano Claudio
Pediatric Department, University of Messina, Italy.
Case Rep Pediatr. 2016;2016:2539374. doi: 10.1155/2016/2539374. Epub 2016 Jan 20.
Dysphagia is an impairment of swallowing that may involve any structures from the mouth to the stomach. Esophageal dysphagia presents with the sensation of food sticking, pain with swallowing, substernal pressure, or chronic heartburn. There are many causes of esophageal dysphagia, such as motility disorders and mechanical and inflammatory diseases. Infrequently dysphagia arises from extrinsic compression of the esophagus from any vascular anomaly of the aortic arch. The most common embryologic abnormality of the aortic arch is aberrant right subclavian artery, clinically known as arteria lusoria. This abnormality is usually silent. Here, we report a case of six-year-old child presenting to us with a history of progressive dysphagia without respiratory symptoms. A barium esophagogram showed an increase of the physiological esophageal narrowing at the level of aortic arch, while at esophagogastroduodenoscopy there was an extrinsic pulsatile compression of the posterior portion of the esophagus suggesting an extrinsic compression by an aberrant vessel. Angio-CT (computed tomography) scan confirmed the presence of an aberrant right subclavian artery.
吞咽困难是指吞咽功能受损，可能涉及从口腔到胃部的任何结构。食管性吞咽困难表现为食物黏附感、吞咽疼痛、胸骨后压迫感或慢性烧心感。食管性吞咽困难有多种原因，如动力障碍、机械性和炎症性疾病。食管吞咽困难很少由主动脉弓的任何血管异常对食管的外在压迫引起。主动脉弓最常见的胚胎学异常是迷走右锁骨下动脉，临床上称为永存动脉弓。这种异常通常没有症状。在此，我们报告一例6岁儿童，有进行性吞咽困难病史，无呼吸道症状。食管钡餐造影显示主动脉弓水平生理性食管狭窄增加，而在食管胃十二指肠镜检查时，食管后部有外在搏动性压迫，提示有异常血管的外在压迫。血管CT扫描证实存在迷走右锁骨下动脉。
