Boutari Rim A, Diab Moustafa W, Mallah Fatmeh I
Gastroenterology and Hepatology, Al Zahraa University Medical Center, Beirut, LBN.
Radiology, Lebanese University Faculty of Medicine, Beirut, LBN.
Cureus. 2025 Feb 11;17(2):e78840. doi: 10.7759/cureus.78840. eCollection 2025 Feb.
Dysphagia lusoria is a rare condition caused by esophageal compression from an aberrant right subclavian artery (ARSA). Although often asymptomatic, complications such as aneurysmal dilation or thrombosis can result in severe presentations, including complete esophageal obstruction. Herein, we report the case of a 75-year-old woman with a five-year history of progressive dysphagia and significant weight loss. During her hospitalization for urosepsis and acute kidney injury, she developed complete esophageal obstruction, preventing oral intake. Imaging revealed an ARSA with significant parietal thrombosis, compressing the esophagus posteriorly. This confirmed the diagnosis of dysphagia lusoria complicated by ARSA thrombosis. Conservative measures failed, and she was referred for vascular surgical evaluation. This case highlights a rare but severe presentation of dysphagia lusoria with complete esophageal obstruction due to ARSA thrombosis. Early recognition and multidisciplinary management are critical for optimizing outcomes. Definitive treatment often requires surgical intervention, particularly in the setting of complications like thrombosis.
迷走右锁骨下动脉(ARSA)压迫食管导致的吞咽困难是一种罕见病症。尽管通常无症状,但诸如动脉瘤样扩张或血栓形成等并发症可导致严重症状,包括完全性食管梗阻。在此,我们报告一例75岁女性患者,有五年进行性吞咽困难病史且体重显著减轻。在她因尿脓毒症和急性肾损伤住院期间,出现了完全性食管梗阻,无法经口进食。影像学检查显示一条伴有明显壁内血栓形成的ARSA,向后压迫食管。这证实了诊断为迷走右锁骨下动脉压迫综合征并发ARSA血栓形成。保守治疗失败,她被转诊进行血管外科评估。该病例凸显了迷走右锁骨下动脉压迫综合征因ARSA血栓形成导致完全性食管梗阻这一罕见但严重的表现。早期识别和多学科管理对于优化治疗结果至关重要。确定性治疗通常需要手术干预尤其在出现血栓形成等并发症的情况下。