Minithoracotomy oesophagectomy for oesophageal carcinoma with aberrant right subclavian artery: a rare case of dysphagia

BMC Gastroenterology

Merrenna IM De Zoysa²  Anuja Abayadeera²  Sumana D Handagala¹  Chathuranga Tisara Keppetiyagama²  Hemantha Sudasinghe²  Duminda Subasinghe² 

[1] Department of Thoracic Surgery, National Hospital for Respiratory Diseases, Welisara, Sri Lanka;University Surgical Unit, The National Hospital of Sri Lanka, Colombo, Sri Lanka

关键词: Dysphagia lusoria;    Oesophageal carcinoma;    Aberrant subclavian artery;   

Others  :  1121813
DOI  :  10.1186/1471-230X-14-163

 received in 2013-09-29, accepted in 2014-09-18,  发布年份 2014

【 摘 要 】

Background

Aberrant R/subclavian artery is a rare congenital anomaly involving aortic arch. Oesophageal carcinoma with associated aberrant R/subclavian artery is very rare and only few cases has been reported in literature. If unrecognized and injured during oesophageal surgery, it can lead to disastrous complications. When associated with oesophageal carcinoma, it can cause diagnostic confusion as the symptoms are similar.

Case presentation

A 60 year old previously healthy female presented with intermittent dysphagia, odynophagia and loss of weight of 3 months duration. She was found to have a oeophageal carcinoma with incidentally co-existing aberrant R/subclavian artery.

Conclusion

Although rare this entity should be considered as a differential diagnosis in a patient with dysphagia. In addition, pre-operative identification is important to prevent intra operative vascular complications. The diagnosis and treatment of this rare condition is discussed in this article.

【 授权许可】

   
2014 Subasinghe et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Miller RG, Robie DK, Davis SL, Cooley DA, Klish WJ, Skolkin MD, Kearney DL, Jaksic T: Survival after aberrant right subclavian artery-oesophageal fistula: case report and literature review. J Vasc Surg 1996, 24:271-275.
• [2]Stone WM, Brewster DC, Moncure AC, Franklin DP, Cambria RP, Abbott WM: Aberrant right subclavian artery: varied presentations and management options. J Vasc Surg 1990, 11:812-817.
• [3]Lichter I: The treatment of dysphagia lusoria in adults. Br J Surg 1963, 50:793-796.
• [4]Wind GG, Valentine RJ (Eds): Anatomic exposures in vascular surgery. Baltimore: Williams and Wilkins; 1991:445-452.
• [5]Pop D, Venissac N, Mouroux J: Video-assisted mediastinoscopy improved radical resection for cancer in transhiatal esophagectomy. J Thorac Cardiovasc Surg 2007, 133:267-268.
• [6]Katariya K, Harvey JC, Pina E, Beattie EJ: Complications of transhiatal esophagectomy. J Surg Oncol 1994, 57:157-163.
• [7]Gandhi SK, Naunheim KS: Complications of transhiatal esophagectomy. Chest Surg Clin North Am 1997, 7:601-610.
• [8]Narumiya K, Nakamura T, Ide H, Takasaki K: Comparison of extended esophagectomy through mini-thoracotomy/laparotomy with conventional thoracotomy/laparotomy for esophageal cancer. Jpn J Thorac Cardiovasc Surg 2005, 53(8):413-419.
• [9]Barloon TJ, Bergus GR, Lu CC: Diagnostic imaging in the evaluation of dysphagia. Am Fam Physician 1996, 53:535-546.
• [10]Bayford D: An account of a singular case of obstructed deglutition.1787. [Mem M Society London 2271]
• [11]Pop D, Venissac N, Nadeemy AS, Schneck A-S, Aze O, Mouroux J: Lesson to be learned: beware of lusoria artery during transhiataloesophagectomy. Ann Thorac Surg 2012, 94:1010-1011.
• [12]Pantvaidya GH, Mistry RC, Ghanekar VR, Upasani VV, Pramesh CS: Injury of an Aberrant Subclavian Artery:A Rare Complication of Video Assisted Thoracoscopic oesophagectomy. Ann Thorac Cardiovasc Surg 2005, 11:35-37.
• [13]Thomas Temes R, Tullis MJ, Patty L, Jorge A: Wernly transhiatal oesophagectomy in a patient with aberrant right subclavian artery. Ann Thorac Surg 1999, 68:2341-2342.
• [14]Lin Y, Li M, Liu XJ: berrant right subclavian artery in video-assisted thoracoscopic esophagectomy. Thorac Dis 2013, 5(4):E137-E139.
• [15]Millar A, Rostom A, Rasuli P, Saloojee N: Upper gastrointestinal bleeding secondary to an aberrant right subclavian artery-esophageal fistula: a case report and review of the literature. Can J Gastroenterol 2007, 20:389-392.