Pulmonary puzzle: A rare case of dysphagia
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.
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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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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