Yang Xiuzhen, Ye Jingjing, Gao Zhan
1Department of Echocardiography,Children's Hospital,School of Medicine,Zhejiang University,Hangzhou,China.
2Centre of Cardiothoracic Surgery,Children's Hospital,School of Medicine,Zhejiang University,Hangzhou,China.
Cardiol Young. 2017 Oct;27(8):1651-1653. doi: 10.1017/S1047951117000919. Epub 2017 May 25.
In this article, we report a rare case of double aortic arch. The case presented initially with a foreign object in the oesophagus. The patient was a 2-year-old boy, who was referred with primary symptoms of tussis (15 days) and emesis (2 days). He had a history of ingesting a coin. Routine chest X-ray indicated a rounded, metal foreign object in the upper oesophagus. A half-Yuan coin was removed by gastroduodenoscopy. Echocardiographic imaging suggested that the patient had double aortic arch, which was subsequently diagnosed by CT angiography with three-dimensional reconstruction. The right subclavian artery arose from the right loop of the double aortic arch. The left subclavian artery as well as left and right common carotid arteries had distinct origins from the left aortic arch. Imaging also indicated atresia of the distal left arch. The patient underwent corrective surgery and made a full recovery. Despite the rarity, double aortic arch should be considered when patients present with a foreign object in the oesophagus. Echocardiography and CT angiography can inform the diagnosis.
在本文中，我们报告了一例罕见的双主动脉弓病例。该病例最初表现为食管内有异物。患者为一名2岁男孩，因咳嗽（15天）和呕吐（2天）的主要症状前来就诊。他有吞食硬币的病史。常规胸部X线检查显示食管上段有一个圆形金属异物。通过胃十二指肠镜取出了一枚五角硬币。超声心动图成像提示患者有双主动脉弓，随后通过CT血管造影三维重建得以确诊。右锁骨下动脉起源于双主动脉弓的右环。左锁骨下动脉以及左右颈总动脉分别起源于左主动脉弓。影像学检查还显示左弓远端闭锁。患者接受了矫正手术并完全康复。尽管双主动脉弓罕见，但当患者出现食管异物时应考虑到这种情况。超声心动图和CT血管造影有助于诊断。
