26 results on '"esophageal compression"'
Search Results
2. Caught in a vice.
- Author
-
Dulam, Vipin, Keshavamurthy, Suresh, Kumaran, Maruti, Hota, Partha, Gutierrez, Carlos, Kashem, Mohammed Abul, and Toyoda, Yoshiya
- Abstract
Esophageal dysmotility and dysphagia are well known in patients with scleroderma. Interstitial lung disease (ILD) in these patients is an indication for lung transplantation but is considered high risk in many centers. This report is an attempt to highlight how anatomical causes can contribute to dysphagia in such patients and complicate the post-operative course after lung transplantation. Such a finding is uncommon in this subset of patients and use of suitable imaging can help in arriving at the diagnosis. We present a patient following lung transplantation for scleroderma related ILD with an aberrant right subclavian artery compressing the esophagus in a vice like grip. Imaging is the key to prompt diagnosis and management. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
3. Vascular Rings and Slings
- Author
-
Park, In Sook, Goo, Hyun Woo, and Park, In Sook, editor
- Published
- 2019
- Full Text
- View/download PDF
4. Largest giant left atrium in rheumatic heart disease.
- Author
-
Pandit, Bhagya Narayan, Aggarwal, Puneet, Subramaniyan, Siva, Gujral, Jaskaran Singh, and Nath, Ranjit Kumar
- Abstract
In the current era of echocardiography, early diagnosis and treatment of rheumatic heart disease make giant left atrium a rare condition, with a reported incidence of 0.3%, and following mainly with rheumatic mitral valve disease. We report a 50-year-old female, a known case of rheumatic heart disease who presented with breathlessness and dysphagia, and the cardiothoracic ratio on chest roentgenogram was 0.95. Echocardiography was suggestive of giant left atrium with a size of 19.4 x 18.3 cm, while magnetic resonance imaging revealed a size of 22.3 x 19.2 x 20.1 cm making it the largest left atrium to be reported in the literature. < Learning objective: Giant left atrium is extremely rare in the current era, and if at all present, it is almost always secondary to rheumatic heart disease. These patients will have long duration of rheumatic heart disease, more chance of atrial fibrillation, compressive symptoms, and thromboembolism. Giant atrium is an indication for anticoagulation even if it is in sinus rhythm.> [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
5. Extremely Late Recovery of Unusual Cervical Ankylosing Spondylitis–Related Dysphagia: Anesthesiologic, Surgical, and Pathophysiological Considerations, and Review of the Literature.
- Author
-
Stifano, Vito, Leone, Antonio, Revelli, Luca, Tosi, Federica, and Visocchi, Massimiliano
- Subjects
- *
DEGLUTITION disorders , *SURGICAL excision , *LITERATURE reviews , *BONES , *INFLAMMATION - Abstract
Ankylosing spondylitis (AS) is an inflammatory disease that involves above all the spine and the pelvis. In the spine, the inflammatory processes cause the formation of syndesmophytes between the vertebral bodies and the ossification of ligaments, with bony overgrowth. In this setting, dysphagia is a rare but severe complication and only a few cases have been reported in the literature. We describe the case of a 50-year-old man suffering from AS, with a 6-month history of severe dysphagia caused by bone compression of the esophagus at the C3-5 level. Because the patient underwent a 10-kg weight loss 2 months after clinical onset, a gastrostomy tube placement was needed. Complete surgical excision of the bone overgrowth via an anterior cervical approach was performed, but despite continuous intensive swallowing rehabilitation therapy, the patient failed to improve in the first following months. Surprisingly, the patient started to improve 18 months after the operation, with a complete recovery from dysphagia 24 months after. Among the 5 reports (including the present case) available in the current literature with a clear dysphagia recovery follow-up, the present case (the second one harboring gastrostomy) is associated with the slowest complete recovery published so far. This unusually late recovery suggests a possible role not only of the mechanical decompression of the esophagus but also of the degeneration/regeneration ratio of the myenteric plexus, along with local neurotransmitters sensitivity changes, to better understand the dysphagia recovery time course of this unique patient. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
6. Airway and esophageal compression from double aortic arch in a case of pentalogy of Fallot: Anesthetic management
- Author
-
Sambhunath Das and Shivani Aggarwal
- Subjects
Airway compression ,double aortic arch ,esophageal compression ,pentalogy of Fallot ,transesophageal echocardiography ,Anesthesiology ,RD78.3-87.3 - Abstract
Double aortic arch (DAA) is a rare disease requiring high index of clinical suspicion for diagnosis. If undiagnosed, it can pose a serious challenge during anesthetic induction because of dynamic nature of tracheal compression. When DAA is associated with other congenital heart diseases, anesthetic management becomes even more challenging. We report the perioperative anesthetic management of a very rare case of DAA associated with pentalogy of Fallot.
- Published
- 2017
- Full Text
- View/download PDF
7. The Clinical Spectrum of Kommerell’s Diverticulum in Adults with a Right-Sided Aortic Arch: A Case Series and Literature Overview
- Author
-
Philippe J. van Rosendael, J. Lauran Stöger, Philippine Kiès, Hubert W. Vliegen, Mark G. Hazekamp, David R. Koolbergen, Hildo J. Lamb, Monique R. M. Jongbloed, and Anastasia D. Egorova
- Subjects
Kommerell’s diverticulum ,right sided aortic arch ,anomalous left subclavian artery ,arteria lusoria ,tracheal compression ,esophageal compression ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Kommerell’s diverticulum is a rare vascular anomaly characterized as an outpouch at the onset of an aberrant subclavian artery. In the variant of a right-sided aortic arch, the trachea and esophagus are enclosed dorsally by the arch. In the configuration of an aberrant left subclavian artery, a Kommerell’s diverticulum and persisting ductus arteriosus or ductal ligament enclose the lateral side, forming a vascular ring which may result in (symptomatic) esophageal or tracheal compression. Spontaneous rupture of an aneurysmatic Kommerell’s diverticulum has also been reported. Due to the rarity of this condition and underreporting in the literature, the clinical implications of a Kommerell’s diverticulum are not well defined. Case summary: We describe seven consecutive adult patients with a right-sided aortic arch and an aberrant course of the left subclavian artery (arteria lusoria), and a Kommerell’s diverticulum, diagnosed in our tertiary hospital. One patient had severe symptoms related to the Kommerell’s diverticulum and underwent surgical repair. In total, two of the patients experienced mild non-limiting dyspnea complaints and in four patients the Kommerell’s diverticulum was incidentally documented on a computed tomography (CT) scan acquired for a different indication. The size of the Kommerell’s diverticulum ranged from 19 × 21 mm to 30 × 29 mm. In the six patients that did not undergo surgery, a strategy of periodic follow-up with structural imaging was pursued. No significant growth of the Kommerell’s diverticulum was observed and none of the patients experienced an acute aortic syndrome to date. Discussion: Kommerell’s diverticulum in the setting of a right-sided aortic arch with an aberrant left subclavian artery is frequently associated with tracheal and esophageal compression and this may result in a varying range of symptoms. Guidelines on management of Kommerell’s diverticulum are currently lacking. This case series and literature overview suggests that serial follow-up is warranted in adult patients with a Kommerell’s diverticulum with small dimensions and no symptoms, however, that surgical intervention should be considered when patients become symptomatic or when the diameter exceeds 30 mm in the absence of symptoms.
- Published
- 2021
- Full Text
- View/download PDF
8. Dysphagia Aortica: Diagnostic Dilemma and Therapeutic Paradigm
- Author
-
Shivanesan Pitchai, Prakash Goura, Ajay Savlania, Subin Sukesan, Tirur Raman Kapilamoorthy, and Madathipat Unnikrishnan
- Subjects
Dysphagia aortica ,esophageal compression ,penetrating aortic ulcer ,thoracic aneurysm ,thoracic endovascular aneurysm repair ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: Intrinsic esophageal pathologies constitute prime cause for dysphagia clinically. However, thoracic esophageal domain is prone to extrinsic compression by various vascular afflictions including aneurysms with attendant therapeutic challenges. Herein, we present a case series of dysphagia aortica with emphasis on its appropriate management option based on grade of dysphagia. Methods: Patients who presented to the vascular division of our tertiary care referral institute between January 2014 and October 2015 with dysphagia due to extrinsic esophageal compression by aneurysmal thoracic aorta form the basis for this report. Prior to referral, all patients were evaluated elsewhere to rule out intrinsic causes and computed tomography angiogram performed delineating aortic aneurysm in four patients and penetrating aortic ulcer in one. Patient cohort included one female and four male patients whose age ranged from 40 to 68 years, with a median of 62 years. Left posterolateral thoracotomy provided access to an aneurysm which was repaired using interposition polyester graft in four patients. Due to severe comorbidities which precluded open surgery, one patient who presented with mild dysphagia was managed by endovascular stent graft repair. Results: Degree of dysphagia was assessed between grades 0 and 4 as in literature. All patients, including four open conventional and one endovascular, recovered well and left hospital totally symptom free. Conclusion: Dysphagia due to vascular diseases in the thoracic domain is an uncommon clinical entity. Patients with thoracic aortic aneurysm presenting with severe dysphagia deserve open surgical repair to provide optimal symptomatic relief in addition to saving life. The state-of-the-art endovascular stent grafting may be considered in very elderly patient having severe comorbidities presenting with mild dysphagia.
- Published
- 2016
- Full Text
- View/download PDF
9. Medical image of the month: Double aortic arch
- Author
-
Wickstrom K, Sears SP, and Meinke L
- Subjects
double aortic arch ,CT scan ,chest x-ray ,dysphagia ,congenital ,tracheal compression ,esophageal compression ,treatment ,mediastinum ,widened mediastinum ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 ,Diseases of the respiratory system ,RC705-779 - Abstract
No abstract available. Article truncated after 150 words. A 78-year-old gentleman presented to the hospital via EMS with altered mental status. An urgent CT of the head performed in the emergency room demonstrated a large, right intraparenchymal hemorrhage with intraventricular extension into the right lateral ventricle. His Glascow Coma Scale score was 6, and he was intubated for airway protection. A chest radiograph performed to verify placement of the endotracheal tube demonstrated prominence of the upper mediastinum in the region of the right paratracheal strip (Figure 1). A CT of the chest (Figure 2) demonstrated a double aortic arch corresponding to the upper mediastinal abnormality noted on the chest radiograph. In speaking with the patient’s family after acquiring the CT of the chest, they stated that the patient had long-term issues with dysphagia – specifically choking with solid foods. Unfortunately, the patient passed away from complications of his large intraparenchymal hemorrhage. A double aortic arch results from persistence of …
- Published
- 2019
- Full Text
- View/download PDF
10. Compression, Extrinsic, Esophagus
- Author
-
Mendoza, Luis H. Ros, Subirán, Ma Eugenia Guillén, Alonso, Cristina Gutiérrez, and Baert, Albert L., editor
- Published
- 2008
- Full Text
- View/download PDF
11. Dysphagia lusoria: uncommon cause of dysphagia in children
- Author
-
Helena Moreira-Silva, Gisela Silva, and Rosa Lima
- Subjects
Aberrant right subclavian artery ,Dysphagia lusoria ,Esophageal compression ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2018
- Full Text
- View/download PDF
12. Double Aortic Arch in an Asymptomatic Adult.
- Author
-
Lee WJ, Shah YK, Ku A, Patel NR, and Maldjian PD
- Abstract
We present a rare double aortic arch (DAA) diagnosis incidentally on CT in a 60-year-old male who presented with pneumonia. DAA is a vascular ring that typically manifests in infants or children due to compression of the esophagus or trachea, resulting in dysphagia or dyspnea. Diagnosis of DAA in adulthood is usually due to the delayed emergence of obstructive symptoms. We present a case of DAA in an adult patient without dysphagia or dyspnea. We discuss factors that can lead to the presentation of DAA in adults. These include an absence of associated congenital disabilities, insufficient tracheal or esophageal constriction in childhood and the onset of compressive symptoms later in life from decreased vascular compliance., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Lee et al.)
- Published
- 2023
- Full Text
- View/download PDF
13. Infant With Recurrent Vomiting and Poor Weight Gain Secondary to an Aberrant Subclavian Artery.
- Author
-
Dugas J, Vozar A, Deskins SJ, and Udassi S
- Abstract
Failure to thrive (FTT) is a term commonly used to characterize slower-than-expected weight gain. While inadequate caloric intake is the predominant cause, failure to thrive is a manifestation of undernutrition often resulting from the interplay of multiple etiologies. This case highlights the diagnosis and management of an infant who presented with recurrent large-volume emesis and poor weight gain secondary to esophageal compression from an aberrant right subclavian artery (ARSA)., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Dugas et al.)
- Published
- 2023
- Full Text
- View/download PDF
14. The clinical spectrum of Kommerell's diverticulum in adults with a right-sided aortic arch
- Author
-
Hildo J. Lamb, Mark G. Hazekamp, Hubert W. Vliegen, J. Lauran Stöger, David R. Koolbergen, Philippine Kiès, Monique R.M. Jongbloed, Philippe J. van Rosendael, and Anastasia D Egorova
- Subjects
Aortic arch ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Kommerell’s diverticulum ,arteria lusoria ,Case Report ,030204 cardiovascular system & hematology ,Vascular anomaly ,Aberrant subclavian artery ,03 medical and health sciences ,0302 clinical medicine ,Ductus arteriosus ,medicine.artery ,medicine ,otorhinolaryngologic diseases ,right sided aortic arch ,Pharmacology (medical) ,General Pharmacology, Toxicology and Pharmaceutics ,Arteria lusoria ,business.industry ,esophageal compression ,anomalous left subclavian artery ,Vascular ring ,Right-sided aortic arch ,medicine.disease ,tracheal compression ,digestive system diseases ,medicine.anatomical_structure ,surgical procedures, operative ,030228 respiratory system ,lcsh:RC666-701 ,Radiology ,medicine.symptom ,business ,Diverticulum - Abstract
Background: Kommerell’s diverticulum is a rare vascular anomaly characterized as an outpouch at the onset of an aberrant subclavian artery. In the variant of a right-sided aortic arch, the trachea and esophagus are enclosed dorsally by the arch. In the configuration of an aberrant left subclavian artery, a Kommerell’s diverticulum and persisting ductus arteriosus or ductal ligament enclose the lateral side, forming a vascular ring which may result in (symptomatic) esophageal or tracheal compression. Spontaneous rupture of an aneurysmatic Kommerell’s diverticulum has also been reported. Due to the rarity of this condition and underreporting in the literature, the clinical implications of a Kommerell’s diverticulum are not well defined. Case summary: We describe seven consecutive adult patients with a right-sided aortic arch and an aberrant course of the left subclavian artery (arteria lusoria), and a Kommerell’s diverticulum, diagnosed in our tertiary hospital. One patient had severe symptoms related to the Kommerell’s diverticulum and underwent surgical repair. In total, two of the patients experienced mild non-limiting dyspnea complaints and in four patients the Kommerell’s diverticulum was incidentally documented on a computed tomography (CT) scan acquired for a different indication. The size of the Kommerell’s diverticulum ranged from 19 × 21 mm to 30 × 29 mm. In the six patients that did not undergo surgery, a strategy of periodic follow-up with structural imaging was pursued. No significant growth of the Kommerell’s diverticulum was observed and none of the patients experienced an acute aortic syndrome to date. Discussion: Kommerell’s diverticulum in the setting of a right-sided aortic arch with an aberrant left subclavian artery is frequently associated with tracheal and esophageal compression and this may result in a varying range of symptoms. Guidelines on management of Kommerell’s diverticulum are currently lacking. This case series and literature overview suggests that serial follow-up is warranted in adult patients with a Kommerell’s diverticulum with small dimensions and no symptoms, however, that surgical intervention should be considered when patients become symptomatic or when the diameter exceeds 30 mm in the absence of symptoms.
- Published
- 2021
15. [Untitled]
- Subjects
Kommerell’s diverticulum ,arteria lusoria ,esophageal compression ,right sided aortic arch ,anomalous left subclavian artery ,tracheal compression - Abstract
Background: Kommerell's diverticulum is a rare vascular anomaly characterized as an outpouch at the onset of an aberrant subclavian artery. In the variant of a right-sided aortic arch, the trachea and esophagus are enclosed dorsally by the arch. In the configuration of an aberrant left subclavian artery, a Kommerell's diverticulum and persisting ductus arteriosus or ductal ligament enclose the lateral side, forming a vascular ring which may result in (symptomatic) esophageal or tracheal compression. Spontaneous rupture of an aneurysmatic Kommerell's diverticulum has also been reported. Due to the rarity of this condition and underreporting in the literature, the clinical implications of a Kommerell's diverticulum are not well defined. Case summary: We describe seven consecutive adult patients with a right-sided aortic arch and an aberrant course of the left subclavian artery (arteria lusoria), and a Kommerell's diverticulum, diagnosed in our tertiary hospital. One patient had severe symptoms related to the Kommerell's diverticulum and underwent surgical repair. In total, two of the patients experienced mild non-limiting dyspnea complaints and in four patients the Kommerell's diverticulum was incidentally documented on a computed tomography (CT) scan acquired for a different indication. The size of the Kommerell's diverticulum ranged from 19 x 21 mm to 30 x 29 mm. In the six patients that did not undergo surgery, a strategy of periodic follow-up with structural imaging was pursued. No significant growth of the Kommerell's diverticulum was observed and none of the patients experienced an acute aortic syndrome to date. Discussion: Kommerell's diverticulum in the setting of a right-sided aortic arch with an aberrant left subclavian artery is frequently associated with tracheal and esophageal compression and this may result in a varying range of symptoms. Guidelines on management of Kommerell's diverticulum are currently lacking. This case series and literature overview suggests that serial follow-up is warranted in adult patients with a Kommerell's diverticulum with small dimensions and no symptoms, however, that surgical intervention should be considered when patients become symptomatic or when the diameter exceeds 30 mm in the absence of symptoms.
- Published
- 2021
16. Airway and esophageal compression from double aortic arch in a case of pentalogy of Fallot: Anesthetic management
- Author
-
Shivani Aggarwal and Sambhunath Das
- Subjects
pentalogy of Fallot ,Double aortic arch ,business.industry ,transesophageal echocardiography ,esophageal compression ,Anesthetic management ,double aortic arch ,Perioperative ,medicine.disease ,Compression (physics) ,lcsh:RD78.3-87.3 ,Anesthetic induction ,lcsh:Anesthesiology ,Anesthesia ,Rare case ,medicine ,business ,Airway ,Airway compression ,Rare disease - Abstract
Double aortic arch (DAA) is a rare disease requiring high index of clinical suspicion for diagnosis. If undiagnosed, it can pose a serious challenge during anesthetic induction because of dynamic nature of tracheal compression. When DAA is associated with other congenital heart diseases, anesthetic management becomes even more challenging. We report the perioperative anesthetic management of a very rare case of DAA associated with pentalogy of Fallot.
- Published
- 2017
17. The Impact of Esophageal Compression on Goiter Symptoms before and after Thyroid Surgery
- Author
-
Helle Døssing, Nina Nguyen, Laszlo Hegedüs, Jesper Roed Sørensen, Steen Joop Bonnema, Filip Alsted Brinch, and Christian Godballe
- Subjects
Quality of life ,medicine.medical_specialty ,Goiter ,Clinical Thyroidology / Original Paper ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Esophageal compression ,03 medical and health sciences ,0302 clinical medicine ,Swallowing ,medicine ,Esophagus ,medicine.diagnostic_test ,business.industry ,Thyroid ,Thyroidectomy ,Magnetic resonance imaging ,Dysphagia ,medicine.disease ,Surgery ,ThyPRO ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine.symptom ,business - Abstract
Introduction: Benign nodular goiter may be associated with swallowing difficulties, but insight into the associated pathophysiology is limited. The aim of this study was to investigate the effect of surgery on the degree of esophageal compression, and its correlation to swallowing difficulties.Methods: Esophageal compression and deviation were evaluated blindly on magnetic resonance imaging (MRI) of the neck, prior to and 6 months after thyroid surgery for symptomatic benign goiter. Goiter symptoms and swallowing difficulties were measured by the Goiter Symptom Scale of the Thyroid-Specific Patient-Reported Outcome (ThyPRO) questionnaire. Cohen's d was used for evaluating effect sizes (ES). Results: Sixty-four patients completed the study. Before surgery, median goiter volume was 57 (range 14-642) mL. The smallest cross-sectional area of the esophagus (SCAE) increased from a median of 95 (47-147) to 137 (72-286) mm 2 (ES = 1.31, p < 0.001). Median esophagus width increased from 15 (range 10-21) to 17 (range 12-24) mm (ES = 0.94, p < 0.001) after surgery, while no statistically significant change was observed for the sagittal dimension (anterior-to-posterior), thus reflecting an increasingly ellipsoid esophageal shape. Median esophageal deviation decreased moderately after surgery from 4 (0-23) to 3 (0-10) mm (ES = 0.54, p = 0.005). The goiter symptom score improved considerably from (mean ± SD) 40 ± 21 to 10 ± 10 points (ES = 1.5, p < 0.001) after surgery, and the improvements were associated with improvements in SCAE ( p = 0.03). Conclusions: In patients with goiter, thyroidectomy leads to substantial improvements in esophageal anatomy, as assessed by MRI, and this correlates with improved swallowing symptoms. This information is valuable in qualifying the dialogue with goiter patients, before deciding on the mode of therapy. Clinicaltrials.gov (NCT03072654).
- Published
- 2019
18. Dysphagia Aortica: Diagnostic Dilemma and Therapeutic Paradigm
- Author
-
Madathipat Unnikrishnan, Prakash Goura, Subin Sukesan, Ajay Savlania, Tirur Raman Kapilamoorthy, and Shivanesan Pitchai
- Subjects
medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Polymers and Plastics ,medicine.medical_treatment ,Thoracic aortic aneurysm ,03 medical and health sciences ,Aortic aneurysm ,0302 clinical medicine ,Aneurysm ,medicine.artery ,medicine ,otorhinolaryngologic diseases ,Thoracic aorta ,General Environmental Science ,Dysphagia aortica ,Surgical repair ,thoracic endovascular aneurysm repair ,business.industry ,esophageal compression ,Stent ,thoracic aneurysm ,030208 emergency & critical care medicine ,medicine.disease ,Symptomatic relief ,Dysphagia ,Surgery ,lcsh:RC666-701 ,penetrating aortic ulcer ,cardiovascular system ,Radiology ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Objective: Intrinsic esophageal pathologies constitute prime cause for dysphagia clinically. However, thoracic esophageal domain is prone to extrinsic compression by various vascular afflictions including aneurysms with attendant therapeutic challenges. Herein, we present a case series of dysphagia aortica with emphasis on its appropriate management option based on grade of dysphagia. Methods: Patients who presented to the vascular division of our tertiary care referral institute between January 2014 and October 2015 with dysphagia due to extrinsic esophageal compression by aneurysmal thoracic aorta form the basis for this report. Prior to referral, all patients were evaluated elsewhere to rule out intrinsic causes and computed tomography angiogram performed delineating aortic aneurysm in four patients and penetrating aortic ulcer in one. Patient cohort included one female and four male patients whose age ranged from 40 to 68 years, with a median of 62 years. Left posterolateral thoracotomy provided access to an aneurysm which was repaired using interposition polyester graft in four patients. Due to severe comorbidities which precluded open surgery, one patient who presented with mild dysphagia was managed by endovascular stent graft repair. Results: Degree of dysphagia was assessed between grades 0 and 4 as in literature. All patients, including four open conventional and one endovascular, recovered well and left hospital totally symptom free. Conclusion: Dysphagia due to vascular diseases in the thoracic domain is an uncommon clinical entity. Patients with thoracic aortic aneurysm presenting with severe dysphagia deserve open surgical repair to provide optimal symptomatic relief in addition to saving life. The state-of-the-art endovascular stent grafting may be considered in very elderly patient having severe comorbidities presenting with mild dysphagia.
- Published
- 2016
19. Radiographic findings in patients with esophageal involvement by mediastinal granuloma.
- Author
-
MacCarty, Robert, Dukes, Russell, Strimlan, C., Dines, David, and Payne, W.
- Abstract
Of 97 patients with mediastinal granuloma, 13 had involvement of the esophagus by extension from adjacent lymph nodes or pleura. A knowledge of the anatomic relationships of these structures is important in understanding the distribution and radiologic features of these lesions. The most common manifestation was extrinsic compression, being present in 7 (54%) of the 13 patients. Three patients (31%) had either a fistula or a sinus tract. Esophageal stricture and diverticulum formation also occurred. Mediastinal granuloma should be considered in the differential diagnosis in patients with any of these findings. [ABSTRACT FROM AUTHOR]
- Published
- 1979
- Full Text
- View/download PDF
20. Medical image of the month: Double aortic arch
- Author
-
Steven Sears, Laura Meinke, and Kelly Wickstrom
- Subjects
CT scan ,Double aortic arch ,treatment ,business.industry ,dysphagia ,lcsh:R5-130.5 ,esophageal compression ,congenital ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,double aortic arch ,widened mediastinum ,Anatomy ,lcsh:RC86-88.9 ,medicine.disease ,tracheal compression ,mediastinum ,chest x-ray ,Medicine ,business ,lcsh:General works - Abstract
No abstract available. Article truncated after 150 words. A 78-year-old gentleman presented to the hospital via EMS with altered mental status. An urgent CT of the head performed in the emergency room demonstrated a large, right intraparenchymal hemorrhage with intraventricular extension into the right lateral ventricle. His Glascow Coma Scale score was 6, and he was intubated for airway protection. A chest radiograph performed to verify placement of the endotracheal tube demonstrated prominence of the upper mediastinum in the region of the right paratracheal strip (Figure 1). A CT of the chest (Figure 2) demonstrated a double aortic arch corresponding to the upper mediastinal abnormality noted on the chest radiograph. In speaking with the patient’s family after acquiring the CT of the chest, they stated that the patient had long-term issues with dysphagia – specifically choking with solid foods. Unfortunately, the patient passed away from complications of his large intraparenchymal hemorrhage. A double aortic arch results from persistence of …
- Published
- 2019
21. The Clinical Spectrum of Kommerell's Diverticulum in Adults with a Right-Sided Aortic Arch: A Case Series and Literature Overview.
- Author
-
van Rosendael PJ, Stöger JL, Kiès P, Vliegen HW, Hazekamp MG, Koolbergen DR, Lamb HJ, Jongbloed MRM, and Egorova AD
- Abstract
Background: Kommerell's diverticulum is a rare vascular anomaly characterized as an outpouch at the onset of an aberrant subclavian artery. In the variant of a right-sided aortic arch, the trachea and esophagus are enclosed dorsally by the arch. In the configuration of an aberrant left subclavian artery, a Kommerell's diverticulum and persisting ductus arteriosus or ductal ligament enclose the lateral side, forming a vascular ring which may result in (symptomatic) esophageal or tracheal compression. Spontaneous rupture of an aneurysmatic Kommerell's diverticulum has also been reported. Due to the rarity of this condition and underreporting in the literature, the clinical implications of a Kommerell's diverticulum are not well defined., Case Summary: We describe seven consecutive adult patients with a right-sided aortic arch and an aberrant course of the left subclavian artery (arteria lusoria), and a Kommerell's diverticulum, diagnosed in our tertiary hospital. One patient had severe symptoms related to the Kommerell's diverticulum and underwent surgical repair. In total, two of the patients experienced mild non-limiting dyspnea complaints and in four patients the Kommerell's diverticulum was incidentally documented on a computed tomography (CT) scan acquired for a different indication. The size of the Kommerell's diverticulum ranged from 19 × 21 mm to 30 × 29 mm. In the six patients that did not undergo surgery, a strategy of periodic follow-up with structural imaging was pursued. No significant growth of the Kommerell's diverticulum was observed and none of the patients experienced an acute aortic syndrome to date., Discussion: Kommerell's diverticulum in the setting of a right-sided aortic arch with an aberrant left subclavian artery is frequently associated with tracheal and esophageal compression and this may result in a varying range of symptoms. Guidelines on management of Kommerell's diverticulum are currently lacking. This case series and literature overview suggests that serial follow-up is warranted in adult patients with a Kommerell's diverticulum with small dimensions and no symptoms, however, that surgical intervention should be considered when patients become symptomatic or when the diameter exceeds 30 mm in the absence of symptoms.
- Published
- 2021
- Full Text
- View/download PDF
22. A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis
- Author
-
Sinan Bağçacı, Hatice Ugurlu, İlknur Albayrak, Ali Salli, and Sami Küçükşen
- Subjects
Male ,medicine.medical_specialty ,Axial skeleton ,Case Report ,Esophageal compression ,Cervical spine ,medicine ,otorhinolaryngologic diseases ,Spondylitis, ankylosing ,Humans ,In patient ,Esophagus ,Spondylitis ,Ankylosing spondylitis ,business.industry ,Osteophyte ,Middle Aged ,medicine.disease ,Dysphagia ,Magnetic Resonance Imaging ,Deglutition disorders ,Surgery ,Deglutition ,medicine.anatomical_structure ,Treatment Outcome ,Esophagography ,Cervical Vertebrae ,Esophageal Stenosis ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.
- Published
- 2013
23. Largest giant left atrium in rheumatic heart disease.
- Author
-
Pandit BN, Aggarwal P, Subramaniyan S, Gujral JS, and Nath RK
- Abstract
In the current era of echocardiography, early diagnosis and treatment of rheumatic heart disease make giant left atrium a rare condition, with a reported incidence of 0.3%, and following mainly with rheumatic mitral valve disease. We report a 50-year-old female, a known case of rheumatic heart disease who presented with breathlessness and dysphagia, and the cardiothoracic ratio on chest roentgenogram was 0.95. Echocardiography was suggestive of giant left atrium with a size of 19.4 x 18.3 cm, while magnetic resonance imaging revealed a size of 22.3 x 19.2 x 20.1 cm making it the largest left atrium to be reported in the literature. < Learning objective: Giant left atrium is extremely rare in the current era, and if at all present, it is almost always secondary to rheumatic heart disease. These patients will have long duration of rheumatic heart disease, more chance of atrial fibrillation, compressive symptoms, and thromboembolism. Giant atrium is an indication for anticoagulation even if it is in sinus rhythm.>., Competing Interests: The authors declare that there is no conflict of interest., (© 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
24. Dysphagia lusoria: uncommon cause of dysphagia in children
- Author
-
Rosa Lima, Gisela Silva, and Helena Silva
- Subjects
Adult ,medicine.medical_specialty ,Cardiovascular Abnormalities ,Dysphagia lusoria ,Subclavian Artery ,RC799-869 ,Extrinsic compression ,Esophageal compression ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.artery ,Aberrant right subclavian artery ,medicine ,otorhinolaryngologic diseases ,Humans ,Esophagus ,030223 otorhinolaryngology ,Child ,Subclavian artery ,medicine.diagnostic_test ,Esophagogastroduodenoscopy ,business.industry ,Gastroenterology ,General Medicine ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Dysphagia ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Radiology ,medicine.symptom ,business ,Deglutition Disorders - Abstract
Dysphagia lusoria (lusus naturae, latin for "freak of nature") describes dysphagia because of vascular compression of the esophagus. Symptoms, when present, occur at the two extremes of life. Owing to the more flexible and compressible nature of the trachea, children usually present with respiratory symptoms, in contrast to adults, who more often present with dysphagia. Here, we report the case of a six-year-old child presenting with a history of progressive dysphagia without respiratory symptoms. A barium esophagogram showed a diagonal impression in the proximal esophagus, while at esophagogastroduodenoscopy there was an extrinsic pulsatile bulging area suggesting an extrinsic compression by an aberrant vessel. Angio-CT (computed tomography) scan confirmed the presence of an aberrant right subclavian artery. info:eu-repo/semantics/publishedVersion
- Published
- 2018
25. The Impact of Esophageal Compression on Goiter Symptoms before and after Thyroid Surgery.
- Author
-
Brinch FA, Døssing H, Nguyen N, Bonnema SJ, Hegedüs L, Godballe C, and Sorensen JR
- Abstract
Introduction: Benign nodular goiter may be associated with swallowing difficulties, but insight into the associated pathophysiology is limited. The aim of this study was to investigate the effect of surgery on the degree of esophageal compression, and its correlation to swallowing difficulties., Methods: Esophageal compression and deviation were evaluated blindly on magnetic resonance imaging (MRI) of the neck, prior to and 6 months after thyroid surgery for symptomatic benign goiter. Goiter symptoms and swallowing difficulties were measured by the Goiter Symptom Scale of the Thyroid-Specific Patient-Reported Outcome (ThyPRO) questionnaire. Cohen's d was used for evaluating effect sizes (ES)., Results: Sixty-four patients completed the study. Before surgery, median goiter volume was 57 (range 14-642) mL. The smallest cross-sectional area of the esophagus (SCAE) increased from a median of 95 (47-147) to 137 (72-286) mm
2 (ES = 1.31, p < 0.001). Median esophagus width increased from 15 (range 10-21) to 17 (range 12-24) mm (ES = 0.94, p < 0.001) after surgery, while no statistically significant change was observed for the sagittal dimension (anterior-to-posterior), thus reflecting an increasingly ellipsoid esophageal shape. Median esophageal deviation decreased moderately after surgery from 4 (0-23) to 3 (0-10) mm (ES = 0.54, p = 0.005). The goiter symptom score improved considerably from (mean ± SD) 40 ± 21 to 10 ± 10 points (ES = 1.5, p < 0.001) after surgery, and the improvements were associated with improvements in SCAE ( p = 0.03)., Conclusions: In patients with goiter, thyroidectomy leads to substantial improvements in esophageal anatomy, as assessed by MRI, and this correlates with improved swallowing symptoms. This information is valuable in qualifying the dialogue with goiter patients, before deciding on the mode of therapy. Clinicaltrials.gov (NCT03072654).- Published
- 2019
- Full Text
- View/download PDF
26. A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis.
- Author
-
Albayrak I, Bağcacı S, Sallı A, Kucuksen S, and Uğurlu H
- Subjects
- Cervical Vertebrae diagnostic imaging, Deglutition, Deglutition Disorders diagnosis, Deglutition Disorders physiopathology, Deglutition Disorders therapy, Esophageal Stenosis diagnosis, Esophageal Stenosis physiopathology, Esophageal Stenosis therapy, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Osteophyte diagnosis, Osteophyte therapy, Spondylitis, Ankylosing diagnosis, Spondylitis, Ankylosing therapy, Tomography, X-Ray Computed, Treatment Outcome, Cervical Vertebrae pathology, Deglutition Disorders etiology, Esophageal Stenosis etiology, Osteophyte etiology, Spondylitis, Ankylosing complications
- Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.
- Published
- 2013
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.