Dysphagia lusoria
Updates to Article Attributes
Dysphagia lusoria is an impairment of swallowing due to compression from an aberrant right subclavian artery (arteria lusoria).
Clinical presentation
Most patients with aberrant right subclavian arteries do not have symptoms. Some present with mild dysphagia, while a small minority have a severe enough disturbance in swallowing that leads to inability to swallow and severe nutritional problems.
In children, the most common presentations are stridor and recurrent chest infections, may be due to their tracheal softening comparing to adult population.
The diagnosis of dysphagia lusoria is always difficult and late as the symptoms are often nonspecific and in the same time, diagnostic endoscopy is negative in more than 50% cases, and manometry has no diagnostic role.
Compression of the oesophagus by the aberrant right subclavian artery can be exacerbated by atherosclerosis or aneurysmal dilatation.
Radiographic features
Plain film
Chest x-ray can demonstrate enlargement of the superior mediastinum.
Fluoroscopy
Barium study of the oesophagus may show the indentation on the posterior esophageal wall by the artery. Chest x-ray can demonstrate enlargement of the superior mediastinum. CT
CT/MRI
CT angiography and MRI thorax are the best diagnostic modalities that could identify the arteria lusoria.
Etymology
The word lusoria comes from the Greek phrase lusus naturae, meaningfreak "freak of nature", which refers to the freakyanomalous course of the artery 1.
Differential Diagnosis
As adult onset of dysphagia lusoria is rare, it should prompt evaluation for other reasons such as malignancy, vascular disease or gastroesophagealgastro-oesophageal reflux disease (GORD) 3,4,5.
-<p><strong>Dysphagia lusoria</strong> is an impairment of swallowing due to compression from an <a href="/articles/aberrant-right-subclavian-artery">aberrant right subclavian artery</a> (arteria lusoria).</p><h4>Clinical presentation</h4><p>Most patients with aberrant right subclavian arteries do not have symptoms. Some present with mild dysphagia, while a small minority have a severe enough disturbance in swallowing that leads to inability to swallow and severe nutritional problems.</p><p>In children, the most common presentations are stridor and recurrent chest infections, may be due to their tracheal softening comparing to adult population.</p><p>The diagnosis of dysphagia lusoria is always difficult and late as the symptoms are often nonspecific and in the same time, diagnostic endoscopy is negative in more than 50% cases, and manometry has no diagnostic role.</p><p>Compression of the oesophagus by the aberrant right subclavian artery can be exacerbated by atherosclerosis or aneurysmal dilatation.</p><h4>Radiographic features</h4><p>Barium study of the oesophagus may show the indentation on the posterior esophageal wall by the artery. Chest x-ray can demonstrate enlargement of the superior mediastinum. CT angiography and MRI thorax are the best diagnostic modalities that could identify the arteria lusoria.</p><h4>Etymology</h4><p>The word <em><strong>lusoria</strong></em> comes from the Greek phrase <em>lusus naturae,</em> meaning <em>freak of nature,</em> which refers to the freaky course of the artery <sup>1</sup>.</p><h4>Differential Diagnosis</h4><p>As adult onset of dysphagia lusoria is rare, it should prompt evaluation for other reasons such as malignancy, vascular disease or <a href="/articles/gastro-oesophageal-reflux-disease">gastroesophageal reflux disease </a>(GERD) <sup>3,4,5. </sup></p>- +<p><strong>Dysphagia lusoria</strong> is an impairment of swallowing due to compression from an <a href="/articles/aberrant-right-subclavian-artery">aberrant right subclavian artery</a> (arteria lusoria).</p><h4>Clinical presentation</h4><p>Most patients with aberrant right subclavian arteries do not have symptoms. Some present with mild dysphagia, while a small minority have a severe enough disturbance in swallowing that leads to inability to swallow and severe nutritional problems.</p><p>In children, the most common presentations are stridor and recurrent chest infections, may be due to their tracheal softening comparing to adult population.</p><p>The diagnosis of dysphagia lusoria is always difficult and late as the symptoms are often nonspecific and in the same time, diagnostic endoscopy is negative in more than 50% cases, and manometry has no diagnostic role.</p><p>Compression of the oesophagus by the aberrant right subclavian artery can be exacerbated by atherosclerosis or aneurysmal dilatation.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>Chest x-ray can demonstrate enlargement of the <a title="Superior mediastinum" href="/articles/superior-mediastinum">superior mediastinum</a>. </p><h5>Fluoroscopy</h5><p>Barium study of the oesophagus may show the indentation on the posterior esophageal wall by the artery. </p><h5>CT/MRI</h5><p><span style="line-height:1.6em">CT angiography and MRI thorax are the best diagnostic modalities that could identify the arteria lusoria.</span></p><h4>Etymology</h4><p>The word <em>lusoria</em> comes from the Greek phrase <em>lusus naturae,</em> meaning "freak of nature", which refers to the anomalous course of the artery <sup>1</sup>.</p><h4>Differential Diagnosis</h4><p>As adult onset of dysphagia lusoria is rare, it should prompt evaluation for other reasons such as malignancy, vascular disease or <a href="/articles/gastro-oesophageal-reflux-disease">gastro-oesophageal reflux disease</a> (GORD) <sup>3,4,5</sup>.</p>
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