Dysphagia lusoria

Dysphagia lusoria

Illustration of the aortic arch anomalies causing Dysphagia lusoria

Dysphagia lusoria is a rare medical condition characterized by difficulty in swallowing due to an abnormality in the aortic arch. The term "lusoria" refers to the Latin word for "strange" or "abnormal." This condition is caused by an anomalous course of the right subclavian artery, which compresses the esophagus and leads to swallowing difficulties.

Symptoms and Diagnosis

Individuals with Dysphagia lusoria often experience symptoms such as dysphagia (difficulty swallowing), regurgitation, chest pain, and weight loss. These symptoms can vary in severity depending on the degree of compression on the esophagus.

Diagnosis of Dysphagia lusoria typically involves a combination of medical history evaluation, physical examination, and imaging studies. Barium swallow studies, esophagoscopy, and computed tomography (CT) scans are commonly used to visualize the abnormality and assess the extent of compression.

Causes and Pathophysiology

Dysphagia lusoria is primarily caused by a developmental anomaly during embryogenesis. During normal development, the fourth branchial arch on the left side of the embryo forms the aortic arch, while the right subclavian artery arises from the seventh intersegmental artery. In Dysphagia lusoria, the right subclavian artery originates from the descending aorta, passing behind the esophagus and causing compression.

The compression of the esophagus by the anomalous artery leads to dysphagia. The severity of symptoms depends on the degree of compression and the presence of associated vascular abnormalities.

Treatment

The treatment of Dysphagia lusoria depends on the severity of symptoms and the patient's overall health. In mild cases, conservative management may be sufficient, including dietary modifications and lifestyle changes to alleviate symptoms. This may involve eating smaller, more frequent meals and avoiding certain foods that exacerbate swallowing difficulties.

In more severe cases, surgical intervention may be necessary. The goal of surgery is to relieve the compression on the esophagus by either repositioning the anomalous artery or creating a bypass to divert blood flow away from the esophagus. The specific surgical approach depends on the individual patient's anatomy and the expertise of the surgical team.

Prognosis

With appropriate treatment, the prognosis for individuals with Dysphagia lusoria is generally favorable. Conservative management can often provide relief from symptoms, while surgical intervention can lead to significant improvement in swallowing function. However, the long-term outcome may vary depending on the severity of the condition and the presence of any associated complications.

See also

• Aortic arch anomalies
• Dysphagia
• Esophagus
• Subclavian artery