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因主动脉弓发出异常椎动脉导致的罕见吞咽困难病例。

Rare case of dysphagia lusoria due to an anomalous vertebral artery originating from the aortic arch.

作者信息

Abdela Abubeker Fedlu, Bezabih Natnael Alemu, Alwan Amir

机构信息

Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia.

出版信息

Radiol Case Rep. 2024 Dec 3;20(2):1179-1181. doi: 10.1016/j.radcr.2024.10.121. eCollection 2025 Feb.

Abstract

Dysphagia lusoria is a rare condition characterized by swallowing difficulties due to vascular compression of the esophagus. While most commonly caused by an aberrant right subclavian artery (ARSA), other vascular anomalies can also lead to this condition. We present a unique case of dysphagia lusoria in a 20-year-old Ethiopian male, caused by a vertebral artery originating anomalously from the aortic arch. The patient presented with a 6-month history of progressive dysphagia, particularly with solid foods. Diagnostic imaging revealed an aberrant right vertebral artery compressing the esophagus. Conservative management, including dietary modifications and swallowing exercises, led to significant symptom improvement. This case highlights the importance of considering rare vascular anomalies in the differential diagnosis of dysphagia, especially in young patients. It also demonstrates the potential effectiveness of conservative management in such cases. This report discusses the clinical presentation, diagnostic approach, and management of this rare variant of dysphagia lusoria.

摘要

先天性血管压迫性吞咽困难是一种罕见的病症,其特征为由于食管受血管压迫而导致吞咽困难。虽然最常见的病因是异常右锁骨下动脉(ARSA),但其他血管异常也可导致这种病症。我们报告了一例独特的先天性血管压迫性吞咽困难病例,患者为一名20岁的埃塞俄比亚男性,病因是椎动脉异常起源于主动脉弓。该患者有6个月进行性吞咽困难病史,尤其是固体食物吞咽困难。诊断性影像学检查显示异常的右椎动脉压迫食管。保守治疗,包括饮食调整和吞咽练习,使症状得到显著改善。该病例突出了在吞咽困难鉴别诊断中考虑罕见血管异常的重要性,尤其是在年轻患者中。它还证明了保守治疗在此类病例中的潜在有效性。本报告讨论了这种罕见的先天性血管压迫性吞咽困难变体的临床表现、诊断方法和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e579/11652868/dab6586e01d3/gr1.jpg

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