Unusual symptomatic late onset presentation of aberrant right subclavian artery: report of two cases and short literature review

Aberrant subclavian arteries are congenital vascular anomalies that usually do not cause any symptoms. When symptomatic they are considered as a rare cause of dysphagia. This presentation is known as dysphagia lusoria. They are diagnosed by barium swallow or contrast-enhanced computed tomography, although it may be an incidental finding. Management varies from life modifications and drug therapy to surgical intervention. We report two cases of the unusual form of late onset symptomatic presentation because of the presence of aberrant right subclavian artery. Main symptom was chest pain without dysphagia. Due to age and medical comorbidities both patients where managed conservatively.

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Imaging spectrum and prevalence of variant branching pattern of aortic arch

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191345 ◽

2019 ◽

Vol 7 (4) ◽

pp. 1313

Author(s):

Vipin Krishnan K. V. ◽

Varun Narayan ◽

Niyaz Ibrahim ◽

John Mathew ◽

Sheen Maria James

Keyword(s):

Computed Tomography ◽

Aortic Arch ◽

Subclavian Artery ◽

Aberrant Right Subclavian Artery ◽

Left Vertebral Artery ◽

Branching Pattern ◽

Contrast Enhanced ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography ◽

Variant Anatomy

Background: Variant branching patterns of the aortic arch are not infrequent but are commonly under reported. This study was conducted to determine the spectrum of Variant branching pattern of aortic arch and their prevalence using contrast enhanced computed tomography (CECT) images of the cases from a tertiary care centre.Methods: Contrast enhanced computed tomography (CECT) images of aortic arch region from 1116(629 male and 487 female) cases from 18 to 85 years of age were examined retrospectively. The images were reviewed for normal and variant anatomy of aortic arch and the results were analyzed statistically.Results: Of 1116 patients, 878 (78.6%) cases showed normal and 238 (21.3%) cases had variant branching pattern of the aortic arch. The most common variation was the common origin of brachiocephalic trunk (BCT) and the left common carotid artery (LCCA) which was observed in 160 (14.3%) cases. In 8 (0.7%) cases, BCT and LCCA took origin from a single common trunk arising from the aortic arch. In 60(5.4%) cases, the left vertebral artery (LVA) originated directly from the aortic arch between the origin of the LCCA and left subclavian artery (SCA). 8 (0.7%) cases had aberrant right subclavian artery. Two (0.2%) cases showed right aortic arch.Conclusions: Interventional radiologists and surgeons should be well aware of variant anatomy of aortic arch. Contrast CT is a highly reliable imaging method for demonstrating anatomical features and variations of the arch.

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Garengeot’s hernia: two case reports with CT diagnosis and literature review

Open Medicine ◽

10.1515/med-2016-0065 ◽

2016 ◽

Vol 11 (1) ◽

pp. 354-360 ◽

Cited By ~ 9

Author(s):

Cristina Garcia-Amador ◽

Roberto De la Plaza ◽

Vladimir Arteaga ◽

Aylhin Lopez-Marcano ◽

Jose Ramia

Keyword(s):

Incidental Finding ◽

Case Reports ◽

Treatment Options ◽

Diagnostic Methods ◽

Open Approach ◽

Contrast Enhanced ◽

Choice Of Treatment ◽

Preoperative Ct ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

AbstractGarengeot’s hernia (GH) is defined as the presence of the appendix inside a femoral hernia. It occurs in 0.9% of femoral hernias and is usually an incidental finding during surgery. Its treatment is controversial and the aim of this article is to review the diagnostic methods and surgical considerations.We report two cases diagnosed preoperatively by contrast-enhanced computed tomography (CT) and discuss the treatment options based on a review of the literature published in PubMed updated on 1 December, 2015.Fifty articles reporting 64 patients (50 women, mean age 70 years) with GH were included in the analysis. Diagnosis was performed by preoperative CT in only 24 cases, including our two. The treatment of GH is emergency surgery. Several options are available laparoscopic or open approach: insertion of a mesh or simple herniorrhaphy, with or without appendectomy.ConslusionThe preoperative diagnosis with CT can guide the choice of treatment. Appendectomy and hernioplasty should be performed via inguinotomy, if there is no perforation or abscess formation.

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DYSPHAGIA LUSORIA: A LATE ONSET PRESENTATION

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i3.143 ◽

2019 ◽

Vol 3 (3) ◽

Author(s):

Dr Ajith Kumar MG ◽

Dr Roja VR

Keyword(s):

Ct Scan ◽

Key Words ◽

Subclavian Artery ◽

Late Onset ◽

Aberrant Right Subclavian Artery ◽

Vascular Compression ◽

Dysphagia Lusoria ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Dysphagia lusoria is the term used to describe dysphagia following vascular compression of oesophagus. Diagnosis can be made by barium and contrast enhanced CT SCAN. The present case describes a late on set dysphagia secondary to aberrant right subclavian artery. Key words: Dysphagia, Dysphagia lusoria, endoscopy, ARSA, CT Scan, ENT, GI and ECG

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Brachiocephalic Vein Aneurysm Treated with Surgery: A Case Report

The Heart Surgery Forum ◽

10.1532/hsf.2571 ◽

2019 ◽

Vol 22 (5) ◽

pp. E357-E359

Author(s):

Jin hong Wi

Keyword(s):

Vascular Graft ◽

Incidental Finding ◽

Median Sternotomy ◽

Rare Condition ◽

Unknown Origin ◽

Brachiocephalic Vein ◽

Postoperative Course ◽

Contrast Enhanced ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

Brachiocephalic vein aneurysm is an extremely rare condition of unknown origin. It may be asymptomatic, presenting as an incidental finding or as a result of complications it causes. We report a case of a 54-year-old man who was asymptomatic and diagnosed with an isolated saccular aneurysm of the left brachiocephalic vein using contrast-enhanced computed tomography. The patient underwent aneurysmectomy through a median sternotomy with no requirement for a vascular graft or cardiopulmonary bypass. The patient had an uneventful postoperative course and remained well two months after the surgery.

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Aberrant right subclavian artery – a rare congenital anatomical variation causing dysphagia lusoria

VASA ◽

10.1024/0301-1526/a000904 ◽

2020 ◽

pp. 1-4

Author(s):

Foivos Irakleidis ◽

Jonathon Kyriakides ◽

Daryll Baker

Keyword(s):

Subclavian Artery ◽

Incidental Finding ◽

Anatomical Variation ◽

Later Life ◽

Aberrant Right Subclavian Artery ◽

Barium Swallow ◽

Common Symptom ◽

Dysphagia Lusoria ◽

Anatomical Anomaly ◽

History Of

Summary: An aberrant right subclavian artery (ARSA) is a rare anatomical variation of the aortic arch. Although an incidental finding and asymptomatic in the majority of individuals, an ARSA can cause troubling symptoms during both childhood and in later life. In adulthood, the most common symptom is dysphagia, where the condition is named dysphagia lusoria. In other rare cases it can cause shortness of breath, chronic cough and hoarseness of voice amongst others. We present a case of a 65-year-old female patient who was diagnosed with dysphagia lusoria following a barium swallow examination to investigate a 10-year history of dysphagia. She was further investigated with other imaging modalities to establish her diagnosis. The dysphagia was not progressive, nor did it result in malnutrition, and hence the patient was managed conservatively. There is currently no established guideline to classify the severity of symptoms or radiological findings of this anatomical anomaly. Our case reiterates the importance of such protocols, in order to be able to avoid the risks of an unnecessary surgical procedure, whilst being sure to prevent the undertreatment of affected individuals.

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