Coles Michael, Madray Victoria M, Mareddy Chinmaya, Kapoor Deepak, Sharma Amol
Augusta University Health Medical Center Augusta Georgia USA.
JGH Open. 2020 May 28;4(6):1238-1239. doi: 10.1002/jgh3.12366. eCollection 2020 Dec.
Dysphagia lusoria is difficulty swallowing as a result of extrinsic esophageal compression by an aberrant right subclavian artery (ARSA). We present the case of a 59-year-old patient with ARSA and history of chronic dysphagia. Vascular decompressive surgery was performed, but it failed to resolve his symptoms. Esophageal manometry indicated concomitant esophageal gastric junction outflow obstruction in the setting of a small hiatal hernia. Our case highlights the diagnostic dilemma surrounding dysphagia lusoria and identification of cases that should undergo surgical repair. Based on a thorough review of the literature and our case, we propose a complete foregut workup for possible other causes as potential etiologies of dysphagia prior to surgical treatment of dysphagia lusoria.
迷走右锁骨下动脉（ARSA）导致食管外部受压，从而引起吞咽困难，即先天性咽下困难。我们报告一例59岁患有ARSA且有慢性吞咽困难病史的患者。患者接受了血管减压手术，但症状未得到缓解。食管测压显示在小食管裂孔疝的情况下伴有食管胃交界处流出道梗阻。我们的病例突出了先天性咽下困难周围的诊断困境以及确定应接受手术修复的病例。基于对文献的全面回顾和我们的病例，我们建议在对先天性咽下困难进行手术治疗之前，对可能的其他原因进行全面的前肠检查，以寻找吞咽困难的潜在病因。
