Case reports

Pulmonary puzzle: A rare case of dysphagia

S Sinha Roy, Coenraad F N Koegelenberg, E M Isusen

Abstract


A 58-year-old man presented with a longstanding history of dysphagia and sensation of something lodged in the back of his throat. He had no significant past medical history, was a smoker (30 pack-years) and used >60 units of alcohol per week. A physical examination was unremarkable. The patient was referred to the respiratory clinic at Tygerberg Hospital, Cape Town, by a specialist physician who was concerned about the patient’s abnormal chest radiograph (Fig. 1). The chest radiograph showed that the normal left-sided aortic arch and the usual companion descending aorta were absent. The arch coursed to the right with the descending aorta also on the right. A computed tomography (CT) scan (Figs 2 and 3) and reconstructions (Figs 4 and 5) confirmed the right-sided aortic arch with a retrooesophageal aberrant left subclavian artery and formation of a Kommerell’s diverticulum at the origin. In the absence of major complications, he was managed conservatively.


Authors' affiliations

S Sinha Roy, Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

Coenraad F N Koegelenberg, Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

E M Isusen, Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

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Keywords

Right sided aortic arch; aberrant subclavian artery; kommerell diverticulum; dysphagia pseudo-lusoria

Cite this article

African Journal of Thoracic and Critical Care Medicine 2016;22(3):73. DOI:10.7196/SARJ.2016.v22i3.81

Article History

Date submitted: 2016-06-05
Date published: 2016-08-01

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African Journal of Thoracic and Critical Care Medicine| Online ISSN: 2617-0205

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