Park Ki Hoon, Baek Sora, Kang Eun Kyoung
Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Korea.
Department of Rehabilitation Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Ann Rehabil Med. 2021 Feb;45(1):79-82. doi: 10.5535/arm.20057. Epub 2021 Feb 9.
High-riding right brachiocephalic and subclavian arteries are often asymptomatic and rare vascular variations. We present a patient with high-riding right brachiocephalic and subclavian arteries that caused compressive pharyngeal and cervical esophageal dysphagia. An 82-year-old woman presented to our hospital with dysphagia that worsened with solid food. A pulsatile lump was observed on the right neck side. A videofluoroscopic swallowing study showed a deviated food bolus movement anterolaterally from the normal vertical pharyngoesophageal transition, with a filling defect in the lower pharynx through the upper esophagus. Neck computed tomography (CT) showed high-riding right brachiocephalic and subclavian arteries and a tortuous right common carotid artery located adjacent to the trachea in the cervical area. The cervical midline structures were deviated to the left neck side. A neck mass with vascular variation should be considered as a cause of dysphagia that worsens with solid food; CT should be considered to determine its cause.
高位右头臂动脉和锁骨下动脉通常无症状，是罕见的血管变异。我们报告一例因高位右头臂动脉和锁骨下动脉导致咽和颈段食管受压性吞咽困难的患者。一名82岁女性因吞咽固体食物时吞咽困难加重前来我院就诊。右侧颈部可观察到一个搏动性肿块。视频荧光吞咽造影显示食物团块运动从正常的垂直咽食管移行处向前外侧偏移，下咽至食管上段有充盈缺损。颈部计算机断层扫描（CT）显示高位右头臂动脉和锁骨下动脉，以及颈段与气管相邻的迂曲右颈总动脉。颈部中线结构向左颈部偏移。应考虑血管变异的颈部肿块是固体食物吞咽困难加重的原因之一；应考虑行CT检查以确定其病因。
