ARTERIA LUSORIAAND KOMMERELL ANEURYSM WITH ESOPHAGEAL FISTULOUS COMMUNICATION: REPORT OF A RARE CASE.

An aberrant right subclavian artery with a kommerell aneurysm is seldom seen. Kommerell aneurysm has the proclivity and inclination to rupture, therefore, accurate diagnosis is critical. We report a case of 80 years old-age man who presented to our emergency department with a 2-month history of mild cough and 2 weeks history of hematemesis. The patient was vitally stable and a chest radiograph was performed to evaluate the pulmonary findings. Significant superior mediastinal widening was noted. CT aortogram showed a contained ruptured aneurysm at the origin of the aberrant right subclavian artery having retro esophageal course with posterior mediastinal hematoma reaching up to carina. Overall findings were suggestive of the variant anatomical origin of the right subclavian artery with kommerell aneurysm and its esophageal fistulous communication. Precise diagnosis plays a crucial role in the successful management of this potentially fatal and lethal condition. [ABSTRACT FROM AUTHOR]