Massaro Nicola, Verro Barbara, Greco Giuseppe, Saraniti Carmelo
Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo, Italy.
Iran J Otorhinolaryngol. 2020 Sep;32(112):333-336. doi: 10.22038/ijorl.2020.46502.2525.
Arteria lusoria is an aberrant right subclavian artery. In symptomatic cases, patients report dysphagia and only in few cases dyspnea, due to external compression of the trachea and esophagus. Symptoms occur in advanced age and diagnosis is made with chest HRCT, when other causes of dysphagia have been excluded.
An 83-year-old woman presented with dyspnea and mechanical dysphagia for solids. Therefore, she did a chest high-resolution computed tomography (HRCT) that showed areas of consolidation of the lung parenchyma, pleural effusion and presence of arteria lusoria, with a retroesophageal course. After 18 days, dysphagia and dyspnea worsened. The new chest HRCT revealed bilateral atelectasis of the lower lung lobes and severe compression of esophagus and trachea along the course of the arteria lusoria.
Considering its dangerousness, this vascular anomaly should be considered in advanced aged patients with dysphagia and dyspnea, once other causes have been excluded.
迷走右锁骨下动脉是一种异常的右锁骨下动脉。在有症状的病例中，患者会出现吞咽困难，仅在少数情况下会因气管和食管受到外部压迫而出现呼吸困难。症状多在老年时出现，当排除了其他吞咽困难的原因后，通过胸部高分辨率CT（HRCT）进行诊断。
一名83岁女性出现呼吸困难和固体食物机械性吞咽困难。因此，她进行了胸部高分辨率计算机断层扫描（HRCT），结果显示肺实质有实变区域、胸腔积液以及存在迷走右锁骨下动脉，走行于食管后方。18天后，吞咽困难和呼吸困难加重。新的胸部HRCT显示下肺叶双侧肺不张，以及沿迷走右锁骨下动脉走行的食管和气管严重受压。
鉴于其危险性，对于出现吞咽困难和呼吸困难的老年患者，一旦排除其他原因，应考虑这种血管异常情况。
