Dysphagia lusoria (or Bayford-Autenrieth dysphagia) is an abnormal condition characterized by difficulty in swallowing caused by an aberrant right
subclavian artery. It was discovered by
David Bayford in 1761 and first reported in a paper by the same in 1787.
Pathophysiology
During development of
aortic arch
The aortic arch, arch of the aorta, or transverse aortic arch () is the part of the aorta between the ascending and descending aorta. The arch travels backward, so that it ultimately runs to the left of the trachea.
Structure
The aorta begins ...
, if the proximal portion of the right fourth arch disappears instead of distal portion, the right subclavian artery will arise as the last branch of aortic arch. It then courses behind the
esophagus
The esophagus ( American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to ...
(or rarely in front of esophagus, or even in front of
trachea
The trachea, also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all air- breathing animals with lungs. The trachea extends from the ...
) to supply blood to right arm. This causes pressure on esophagus and results in
dysphagia
Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right.
It may be a sensation that suggests difficulty in the passage of solids or liq ...
. It can sometimes result in upper gastrointestinal tract bleeding.
Investigation of choice - CT angiography
Treatment
Surgical repair is performed. Reconstruction or ligation of aberrant right subclavian artery by sternotomy/by neck approach.
Eponym
David Bayford called it dysphagia lusoria because in Latin, ''lusus naturæ'' means ''sports of nature'' or ''natural anomaly''.
Bayford-Autenrieth dysphagia is eponym for
Bayford and
Autenrieth.
See also
*
Aberrant subclavian artery
Aberrant subclavian artery, or aberrant subclavian artery syndrome, is a rare anatomical variant of the origin of the right or left subclavian artery. This abnormality is the most common congenital vascular anomaly of the aortic arch, occurring i ...
*
Ortner's syndrome
References
External links
{{Medical resources
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, Orphanet = 99082
Cardiovascular diseases