10.DYSPHAGIA LUSORIA

A.ABERRANT RIGHT SUBCLAVIAN ARTERY
B.
C.
D.

ANS: ABERRANT RIGHT SUBCLAVIAN ARTERY


Dyspahagia lusoria is a congenital vascular anomly involving aberrant right subclavian artery.
The most common embryologic abnormality of the aortic arch is an aberrant right subclavian artery, which occurs in 0.5% to 1.8% of the population.

As hypothesized by Edwards, this abnormal origin of the right subclavian artery can be explained by the involution of the 4th vascular arch with the right dorsal aorta. The 7th intersegmental artery remains attached to the descending aorta, and this persistent intersegmental artery becomes the right subclavian artery. This leads to the aberrant artery, which often follows a retro-esophageal course.

Overview of Arch Anomalies

1.Aberrant Right subclavian artery
Most common arch anomaly
Not a true ring
Usually asymptomatic
Sometimes dysphagia lusoria when dilated suvclavian artery compresses esophagus posteriorly.

2.Innominate artery compression syndrome
In children the brachiocephalic (innominate) artery is located more to the left and may compresses the trachea anteriorly.

3.Right Arch Mirror Image
Mirror-image variety of the left arch
Asymptomatic
Associated congenital heart disease in 98%, mostly tetralogy of Fallot.

4.Right Arch with Aberrant left subclavian
Left subclavian artery is the last branch.
Obstructing anomaly.

5.Double Aortic Arch
Complete ring encircles esophagus and trachea
Four vessel sign.

6.Double Arch with Atretic Segment
Left arch is very small and has atretic posterior segment.
Still a four vessel sign.