Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular Ring

A 49-year-old African American male patient with no past medical history was admitted because of 3 months of difficulty swallowing solid and liquid foods. He had constant retrosternal discomfort and appeared malnourished. The chest radiograph revealed a right sided aortic arch with tracheal deviatio...

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Main Authors: Ankur Sinha, Hitesh Raheja, Vinod Namana, Sunil Abrol, Stephan Kamholz, Vijay Shetty
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2017/9614835
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author Ankur Sinha
Hitesh Raheja
Vinod Namana
Sunil Abrol
Stephan Kamholz
Vijay Shetty
author_facet Ankur Sinha
Hitesh Raheja
Vinod Namana
Sunil Abrol
Stephan Kamholz
Vijay Shetty
author_sort Ankur Sinha
collection DOAJ
description A 49-year-old African American male patient with no past medical history was admitted because of 3 months of difficulty swallowing solid and liquid foods. He had constant retrosternal discomfort and appeared malnourished. The chest radiograph revealed a right sided aortic arch with tracheal deviation to the left. A swallow study confirmed a fixed esophageal narrowing at the level of T6. Contrast enhanced Computed Tomography (CT) angiogram of the chest and neck revealed a mirror image right aortic arch with a left sided cardiac apex and a prominent ductus diverticulum (measuring 1.7 × 1.8 cm). This structure extended posterior to and indented the mid esophagus. A left posterolateral thoracotomy was performed and the ductus diverticulum was resected. A retroesophageal ligamentum arteriosum was found during surgery and divided. This rare combination of congenital anatomical aberrations led to severe dysphagia in our patient. Successful surgical correction in the form of resection of the ductus diverticulum and division of the retroesophageal ligamentum arteriosum led to complete resolution of our patient’s symptoms.
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series Case Reports in Cardiology
spelling doaj-art-e868e8f2e0f941ada88482d5985d92f12025-08-20T02:21:38ZengWileyCase Reports in Cardiology2090-64042090-64122017-01-01201710.1155/2017/96148359614835Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular RingAnkur Sinha0Hitesh Raheja1Vinod Namana2Sunil Abrol3Stephan Kamholz4Vijay Shetty5Departments of Medicine and Cardiology, Maimonides Medical Center, Brooklyn, NY, USADepartments of Medicine and Cardiology, Maimonides Medical Center, Brooklyn, NY, USADepartments of Medicine and Cardiology, Maimonides Medical Center, Brooklyn, NY, USADepartment of Cardiothoracic Surgery, Maimonides Medical Center, Brooklyn, NY, USADivisions of Pulmonary Medicine and Critical Care Medicine, Maimonides Medical Center, Brooklyn, NY, USADepartments of Medicine and Cardiology, Maimonides Medical Center, Brooklyn, NY, USAA 49-year-old African American male patient with no past medical history was admitted because of 3 months of difficulty swallowing solid and liquid foods. He had constant retrosternal discomfort and appeared malnourished. The chest radiograph revealed a right sided aortic arch with tracheal deviation to the left. A swallow study confirmed a fixed esophageal narrowing at the level of T6. Contrast enhanced Computed Tomography (CT) angiogram of the chest and neck revealed a mirror image right aortic arch with a left sided cardiac apex and a prominent ductus diverticulum (measuring 1.7 × 1.8 cm). This structure extended posterior to and indented the mid esophagus. A left posterolateral thoracotomy was performed and the ductus diverticulum was resected. A retroesophageal ligamentum arteriosum was found during surgery and divided. This rare combination of congenital anatomical aberrations led to severe dysphagia in our patient. Successful surgical correction in the form of resection of the ductus diverticulum and division of the retroesophageal ligamentum arteriosum led to complete resolution of our patient’s symptoms.http://dx.doi.org/10.1155/2017/9614835
spellingShingle Ankur Sinha
Hitesh Raheja
Vinod Namana
Sunil Abrol
Stephan Kamholz
Vijay Shetty
Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular Ring
Case Reports in Cardiology
title Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular Ring
title_full Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular Ring
title_fullStr Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular Ring
title_full_unstemmed Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular Ring
title_short Adult Onset Dysphagia: Right Sided Aortic Arch, Ductus Diverticulum, and Retroesophageal Ligamentum Arteriosum Comprising an Obstructing Vascular Ring
title_sort adult onset dysphagia right sided aortic arch ductus diverticulum and retroesophageal ligamentum arteriosum comprising an obstructing vascular ring
url http://dx.doi.org/10.1155/2017/9614835
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