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dc.contributor.authorPowell, BL
dc.identifier.citationAnn R Coll Surg Engl. 2017 Jan;99(1):e3-e5. doi: 10.1308/rcsann.2016.0232. Epub 2016 Aug 23.language
dc.description.abstractA 48-year-old woman was seen in a surgical outpatient clinic with a 2 year history of progressive dysphagia with occasional regurgitation, partially controlled with a proton pump inhibitor. Primary investigations of pH testing and gastroscopy were normal, although a barium swallow study revealed significant hold-up at the aortic arch impression and a posterior right-sided oesophageal impression suggestive of a right-sided aortic arch. A follow-up computed tomography angiogram discovered a vascular ring encircling the trachea and oesophagus, formed by a right-sided aortic arch with aberrant aortic branches, and a Kommerell's diverticulum. It was deemed that the patient's symptoms were related to this vascular ring. The patient underwent stage-one surgery - an extra-anatomic bypass of the double aortic arch and right subclavian artery - and 4 months later a stent graft insertion over the origin of the diverticulum with the aim of complete symptomatic relief. This case presents a common symptom familiar to any clinician (dysphagia), which has been caused by a rare pathology. It is even more unusual that this should present itself in adulthood.language
dc.subjectAdult; Dysphagia; Kommerell’s diverticulum; Vascular ringlanguage
dc.titleVascular ring presenting as dysphagia in an adult woman: a case reportlanguage

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